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Konrath E, Marhold F, Kindler W, Scheichel F, Popadic B, Blauensteiner K, Calabek-Wohinz B, Freydl E, Weber M, Ristl R, Hainz K, Sherif C, Oberndorfer S. P01.08.A Perioperative Levetiracetam for seizure prophylaxis in seizure naive brain tumor patients with focus on neurocognitive functioning. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In seizure-naive brain tumor patients, the efficacy of perioperative prophylactic antiepileptic drugtreatment remains controversial. In case of administration, the common preferred drug is levetiracetam (LEV) because of its favorable pharmacological profile. Research to date has not sufficiently determined how LEV affects cognition in the short term as it does in the perioperative period. The objective of this prospective study was to examine the neurocognitive functioning of seizure-naive brain tumor patients after receiving LEV perioperatively.
Material and methods
Patients with supratentorial brain tumor undergoing surgery received LEV three days before until seven days after surgery as seizure prophylaxis. Cognitive functioning (NeuroCogFX), LEV plasma-levels, hematotoxicity, side-effects, as well as health-related quality of life (HRQoL, Qolie31), were recorded preoperatively before (Baseline) and after onset of LEV (Pre-Op), 4-6 days postoperatively (Post-Op) and 21 days postoperatively (Follow-Up).
Results
No significant changes in cognitive functioning and HRQoL were seen after onset of preoperative LEV. There was a significant improvement of NeuroCogFX total-score at Follow-Up (p=0.004) compared to Baseline. The overall-score Qolie31 showed simultaneous improvement patterns as cognitive functioning (p< 0.001). The most frequent side effect related to study drug was somnolence (in 24% of patients).
Conclusion
Following LEV therapy, a significant improvement of cognitive functioning, as well as an improvement in HRQoL, were detected postoperatively. This is presumably due to the debulking effect of the surgery. Nevertheless, LEV has no detrimental effect on cognitivefunctioning in the perioperative phase in seizure-naive brain tumor patients.
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Affiliation(s)
- E Konrath
- Klinische Abteilung für Neurologie , St. Pölten , Austria
| | - F Marhold
- Klinische Abteilung für Neurochirurgie , St. Pölten , Austria
| | - W Kindler
- Klinische Abteilung für Neurologie , St. Pölten , Austria
| | - F Scheichel
- Klinische Abteilung für Neurochirurgie , St. Pölten , Austria
| | - B Popadic
- Klinische Abteilung für Neurochirurgie , St. Pölten , Austria
| | | | | | - E Freydl
- Klinische Abteilung für Neurologie , St. Pölten , Austria
| | - M Weber
- Karl Landsteiner Privatuniversität für Gesundheitswissenschaften , Krems , Austria
| | - R Ristl
- Medizinische Universität Wien , Wien , Austria
| | - K Hainz
- Klinische Abteilung für Neurologie , St. Pölten , Austria
| | - C Sherif
- Klinische Abteilung für Neurochirurgie , St. Pölten , Austria
| | - S Oberndorfer
- Klinische Abteilung für Neurologie , St. Pölten , Austria
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