Brain Tumor Res Treat.  2021 Apr;9(1):9-15. 10.14791/btrt.2021.9.e7.

The Korean Society for Neuro-Oncology (KSNO) Guideline for Antiepileptic Drug Usage of Brain Tumor: Version 2021.1

• Moon J
• Kim MS
• Kim YZ
• Hwang K
• Park JE
• Kim KH
• Cho JM
• Yoon WS
• Kim SH
• Kim YI
• Kim HS
• Dho YS
• Park JS
• Yoon HI
• Seo Y
• Sung KS
• Song JH
• Wee CW
• Lee MH
• Han MH
• Hong JB
• Im JH
• Lee SH
• Chang JH
• Lim DH
• Park CK
• Lee YS
• Gwak HS
• KSNO Guideline Working Group

• KMID: 2515076
• DOI: http://doi.org/10.14791/btrt.2021.9.e7

Abstract

Background
To date, there has been no practical guidelines for the prescription of antiepileptic drugs (AEDs) in brain tumor patients in Korea. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, had begun preparing guidelines for AED usage in brain tumors since 2019.
Methods
The Working Group was composed of 27 multidisciplinary medical experts in Korea. References were identified through searches of PubMed, MEDLINE, EMBASE, and Cochrane CENTRAL using specific and sensitive keywords as well as combinations of the keywords.
Results
The core contents are as follows. Prophylactic AED administration is not recommended in newly diagnosed brain tumor patients without previous seizure history. When AEDs are administered during peri/postoperative period, it may be tapered off according to the following recommendations. In seizure-naïve patients with no postoperative seizure, it is recommended to stop or reduce AED 1 week after surgery. In seizure-naïve patients with one early postoperative seizure (<1 week after surgery), it is advisable to maintain AED for at least 3 months before tapering. In seizure-naïve patients with ≥2 postoperative seizures or in patients with preoperative seizure history, it is recommended to maintain AEDs for more than 1 year. The possibility of drug interactions should be considered when selecting AEDs in brain tumor patients. Driving can be allowed in brain tumor patients when proven to be seizure-free for more than 1 year.
Conclusion
The KSNO suggests prescribing AEDs in patients with brain tumor based on the current guideline. This guideline will contribute to spreading evidence-based prescription of AEDs in brain tumor patients in Korea.

Keyword

Korean Society for Neuro-Oncology; Guideline; Brain tumors; Antiepileptic drug; Practice

Figure

• 

  Fig. 1 Guideline for AED maintenance and withdrawal in brain tumor patients. Sz, seizure; Hx, history; PostOp, postoperative; EEG, electroencephalogram; PreOp, preoperative; LOC, loss of consciousness; AED, antiepileptic drug.

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