TY - JOUR
T1 - The pathogenesis of tumor-related epilepsy and its implications for clinical treatment
AU - You, Gan
AU - Sha, Zhiyi
AU - Jiang, Tao
PY - 2012/4
Y1 - 2012/4
N2 - Approximately 30-50% of patients with brain tumors present with seizures as the initial symptom. Seizures play a very important role in the quality of life, particularly in patients with slow-growing primary brain tumors. Tumor-related seizures are often refractory to antiepileptic treatment. Despite the importance of this subject to the fields of neurology, neurosurgery and neurooncology, the pathogenesis of tumor-related epilepsy remains poorly understood. This review summarizes possible mechanisms underlying the pathogenesis of tumor-related epilepsy, including both tumoral and peri-tumoral aspects. Tumor cells themselves may create intrinsic epileptogenicity, and inadequate homeostasis in the peri-tumoral tissues may lead to seizure susceptibility. Other local changes in electrolytes, perfusion, metabolism, and enzymes could also contribute. It is generally accepted that changes in amino acid neurotransmission are the most important mechanism underlying tumor-related seizures, and changes in extracellular ions also play an important role. Hypoxia, acidosis, and metabolic, immunological, and inflammatory changes may also be involved in the occurrence of seizures. Knowledge of these mechanisms may provide guidance in the search for new strategies for the surgical and medical treatment of tumor-related epilepsy.
AB - Approximately 30-50% of patients with brain tumors present with seizures as the initial symptom. Seizures play a very important role in the quality of life, particularly in patients with slow-growing primary brain tumors. Tumor-related seizures are often refractory to antiepileptic treatment. Despite the importance of this subject to the fields of neurology, neurosurgery and neurooncology, the pathogenesis of tumor-related epilepsy remains poorly understood. This review summarizes possible mechanisms underlying the pathogenesis of tumor-related epilepsy, including both tumoral and peri-tumoral aspects. Tumor cells themselves may create intrinsic epileptogenicity, and inadequate homeostasis in the peri-tumoral tissues may lead to seizure susceptibility. Other local changes in electrolytes, perfusion, metabolism, and enzymes could also contribute. It is generally accepted that changes in amino acid neurotransmission are the most important mechanism underlying tumor-related seizures, and changes in extracellular ions also play an important role. Hypoxia, acidosis, and metabolic, immunological, and inflammatory changes may also be involved in the occurrence of seizures. Knowledge of these mechanisms may provide guidance in the search for new strategies for the surgical and medical treatment of tumor-related epilepsy.
KW - Brain tumor
KW - Epilepsy
KW - Pathogenesis
KW - Seizure
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=84858078310&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84858078310&partnerID=8YFLogxK
U2 - 10.1016/j.seizure.2011.12.016
DO - 10.1016/j.seizure.2011.12.016
M3 - Review article
C2 - 22300623
AN - SCOPUS:84858078310
SN - 1059-1311
VL - 21
SP - 153
EP - 159
JO - Seizure
JF - Seizure
IS - 3
ER -