How do you manage AEDs in patients with malignant brain tumors?

Use of prophylactic anti-seizure drugs in patients with primary malignant brain tumors is not recommended and has been evaluated in multiple systematic reviews and guidelines including a recent systematic review and well-done guideline paper from SNO and EANO published by Tobias Walbert, Elizabeth G...

The key issues and approach have been well-articulated:

1. AEDs have a significant toxicity profile and no categorical benefit in patients without seizures and therefore should not be used. There is no need to "cover" patients receiving radiotherapy with AEDs; in fact, indirect data (such as the EORTC...

They may want to prescribe it for a short time 2 or a few weeks to prevent seizures while the patient is going through surgery or complications afterward.

If any patient needs long term treatment, I personally prefer Lamictal, Aptiom, or Xcorpi. The last one seems to have less interactions with ch...

Excellent analysis and response. The 2016 study was what we always quoted to Neurology and Neurosurgery in residency. The only thing I would add is the simple fact that most patients are miserable on these meds and the most commonly used anti-epileptic, Keppra, gives many patients a feeling of being...

Excellent review from Dr. @Dr. First Last. There is also data suggesting that anti-epileptic use such as levetiracetam was associated with worse scores on process speed, attention, and executive function (Klein et al., PMID 12423981), so agree effort should be to minimize unnecessary anti-epileptics...