Epilepsy in patients with glioblastoma: Mechanisms of occurrence and problems of treatment (part 2)

Abstract

Epilepsy caused by glioblastoma requires careful study of the combination of factors causing it, with an integrated approach to prevention and complete relief when seizures occur against the background of adequate and modern treatment regimens. Control of seizures often requires the administration of antiepileptic drugs concomitantly with other treatments, including surgery, radiation, and chemotherapy. Pharmacological interactions between antiepileptic drugs and antineoplastic agents may alter the activity of both treatments, reducing their effectiveness and increasing the likelihood of side effects associated with both therapies. The presented literature review summarizes novel pathophysiological pathways associated with glioblastoma and involved in epileptogenesis, and also describes the interaction between antiepileptic drugs and oncological treatment. The article focuses on the impact of treatment on survival and presents evidence of the effectiveness of antiepileptic treatment, including the potential usefulness of new third-generation antiepileptic drugs. The second part of the article discusses in detail aspects of both preventive and symptomatic treatment of patients with epilepsy associated with glioblastomas.