The role of prophylactic anticonvulsants in the management of brain metastases: a systematic review and evidence-based clinical practice guideline.

Authors

Tom Mikkelsen, Henry Ford Health System, Detroit, MIFollow
Nina A Paleologos, Northshore University Health System, Evanston, ILFollow
Paula D Robinson, McMaster University Evidence-Based Practice Centre, OntarioFollow
Mario Ammirati, Ohio State University Medical Center, Columbus, OHFollow
David W Andrews, Thomas Jefferson UniversityFollow
Anthony L Asher, Carolina Neurosurgery and Spine Associates, Charlotte, NCFollow
Stuart H Burri, Carolinas Medical Center, Charlotte, NCFollow
Charles S Cobbs, California Pacific Medical Center, San Francisco, CAFollow
Laurie E Gaspar, University of Colorado-Denver, Denver, COFollow
Douglas Kondziolka, University of Pittsburgh Medical Center, Pittsburgh, PAFollow
Mark E Linskey, University of California-Irvine Medical Center, Orange, CAFollow
Jay S Loeffler, Massachusetts General Hospital, Boston, MAFollow
Michael McDermott, University of California San Francisco, San Francisco, CAFollow
Minesh P Mehta, University of Wisconsin School of Public Health and Medicine, Madison, WIFollow
Jeffrey J Olson, Emory University School of Medicine, Atlanta, GAFollow
Roy A Patchell, Barrow Neurological Institute, Phoenix, AZFollow
Timothy C Ryken, Iowa Spine and Brain Institute, Iowa City, IAFollow
Steven N Kalkanis, Department of Neurosurgery, Henry Ford Health System, 2799 West Grand Blvd, K-11, Detroit, MIFollow

Document Type

Article

Publication Date

1-1-2010

Comments

This article has been peer reviewed. It was published in: Journal of Neuro-Oncology

Volume 96, Issue 1, January 2010, Pages 97-102.

The published version is available at DOI: 10.1007/s11060-009-0056-5. Copyright © Springer

Abstract

QUESTION: Do prophylactic anticonvulsants decrease the risk of seizure in patients with metastatic brain tumors compared with no treatment?

TARGET POPULATION: These recommendations apply to adults with solid brain metastases who have not experienced a seizure due to their metastatic brain disease.

RECOMMENDATION: Level 3 For adults with brain metastases who have not experienced a seizure due to their metastatic brain disease, routine prophylactic use of anticonvulsants is not recommended. Only a single underpowered randomized controlled trial (RCT), which did not detect a difference in seizure occurrence, provides evidence for decision-making purposes.

Recommended Citation

Mikkelsen, Tom; Paleologos, Nina A; Robinson, Paula D; Ammirati, Mario; Andrews, David W; Asher, Anthony L; Burri, Stuart H; Cobbs, Charles S; Gaspar, Laurie E; Kondziolka, Douglas; Linskey, Mark E; Loeffler, Jay S; McDermott, Michael; Mehta, Minesh P; Olson, Jeffrey J; Patchell, Roy A; Ryken, Timothy C; and Kalkanis, Steven N, "The role of prophylactic anticonvulsants in the management of brain metastases: a systematic review and evidence-based clinical practice guideline." (2010). Department of Neurosurgery Faculty Papers. Paper 41.
https://jdc.jefferson.edu/neurosurgeryfp/41

PubMed ID

19957015