Abstract：
OBJECTIVE: Brain tumor-related epilepsy is a heterogenous syndrome involving variability in incidence, timing, pathophysiology, and clinical risk factors for seizures across different brain tumor pathologies. Seizure risk and disability are dynamic over the course of disease and influenced by tumor-directed treatments, necessitating individualized patient-centered management strategies to optimize quality of life.
RESULTS: Recent translational findings in diffuse gliomas indicate a dynamic bidirectional relationship between glioma growth and hyperexcitability. Certain non-invasive measures of hyperexcitability are correlated with survival outcomes, however it remains uncertain how to define and measure clinically relevant hyperexcitability serially over time. The extent of resection, timing of pre-operative and/or post-operative seizures, and the likelihood of tumor progression are critical factors impacting the risk of seizure recurrence. Newer anti-seizure medications are generally well-tolerated with similar efficacy in this population, and several rapid-onset seizure rescue agents are in development and available. Seizures in patients with brain tumors are strongly influenced by the underlying tumor biology and treatment. An improved understanding of the interactions between tumor cells and the spectrum of hyperexcitability will facilitate targeted therapies. Multidisciplinary management of seizures should occur with consideration of tumor-directed therapy and prognosis, and anti-seizure medication decision-making tailored to the individual priorities and quality of life of the patient.
RESULTS: Recent translational findings in diffuse gliomas indicate a dynamic bidirectional relationship between glioma growth and hyperexcitability. Certain non-invasive measures of hyperexcitability are correlated with survival outcomes, however it remains uncertain how to define and measure clinically relevant hyperexcitability serially over time. The extent of resection, timing of pre-operative and/or post-operative seizures, and the likelihood of tumor progression are critical factors impacting the risk of seizure recurrence. Newer anti-seizure medications are generally well-tolerated with similar efficacy in this population, and several rapid-onset seizure rescue agents are in development and available. Seizures in patients with brain tumors are strongly influenced by the underlying tumor biology and treatment. An improved understanding of the interactions between tumor cells and the spectrum of hyperexcitability will facilitate targeted therapies. Multidisciplinary management of seizures should occur with consideration of tumor-directed therapy and prognosis, and anti-seizure medication decision-making tailored to the individual priorities and quality of life of the patient.
摘要：
目的：脑肿瘤相关癫痫是一种异质性综合征，涉及发病率的变异性，定时,病理生理学,以及不同脑肿瘤病理中癫痫发作的临床危险因素。癫痫发作风险和残疾在疾病过程中是动态的，并受肿瘤导向治疗的影响。需要个性化的以患者为中心的管理策略来优化生活质量。
结果：最近在弥漫性神经胶质瘤中的转化发现表明神经胶质瘤生长和过度兴奋之间存在动态的双向关系。某些非侵入性的过度兴奋措施与生存结局相关，然而,随着时间的推移,如何定义和测量临床相关的过度兴奋性仍不确定.切除的程度，术前和/或术后癫痫发作的时间，肿瘤进展的可能性是影响癫痫复发风险的关键因素。较新的抗癫痫药物通常具有良好的耐受性，在该人群中具有相似的疗效。几种快速发作的癫痫发作救援剂正在开发中并可用。脑肿瘤患者的癫痫发作受到潜在的肿瘤生物学和治疗的强烈影响。对肿瘤细胞之间的相互作用和过度兴奋谱的更好理解将有助于靶向治疗。癫痫发作的多学科管理应考虑肿瘤导向治疗和预后，以及针对患者个人优先事项和生活质量的抗癫痫药物决策。
结果：最近在弥漫性神经胶质瘤中的转化发现表明神经胶质瘤生长和过度兴奋之间存在动态的双向关系。某些非侵入性的过度兴奋措施与生存结局相关，然而,随着时间的推移,如何定义和测量临床相关的过度兴奋性仍不确定.切除的程度，术前和/或术后癫痫发作的时间，肿瘤进展的可能性是影响癫痫复发风险的关键因素。较新的抗癫痫药物通常具有良好的耐受性，在该人群中具有相似的疗效。几种快速发作的癫痫发作救援剂正在开发中并可用。脑肿瘤患者的癫痫发作受到潜在的肿瘤生物学和治疗的强烈影响。对肿瘤细胞之间的相互作用和过度兴奋谱的更好理解将有助于靶向治疗。癫痫发作的多学科管理应考虑肿瘤导向治疗和预后，以及针对患者个人优先事项和生活质量的抗癫痫药物决策。
