Epilepsy associated with pituitary neuroendocrine tumors: Current status of problem and interdisciplinary approach

Abstract

This literature review is devoted to the problem of epilepsy caused by pituitary neuroendocrine tumors: their detailed classification with the latest recommendations of the World Health Organization 2022, clinical picture of each variant of pituitary neuroendocrine tumor in a complex multidisciplinary approach are considered. The main feature of the review is a detailed consideration of the epilepsy associated with this condition, which is considered to be a rather rare manifestation of the disease (incidence in patients is 0.5 %), due to which very few cases of epilepsy in patients with pituitary adenoma have been described in the literature. Our work has analyzed the fundamental works of domestic scientists in this field, as well as current information from foreign sources and most of the available clinical cases of epilepsy in this group of patients, revealing in detail the pathogenesis of epilepsy at all levels, including molecular changes. Modern techniques for the treatment approach in this group of patients are also described, the effectiveness of drug and surgical therapy is analyzed according to the criteria of the frequency of long-term persistent remission and recurrence, side effects of drugs and complications of transsphenoidal tumor resection are reviewed, including in terms of possible epilepsy; conclusions about the most rational and effective approach to treatment of various types of hypophysial neuroendocrine tumors are drawn.