Observational studyJournal of neuro-oncology2019
Withdrawal of antiepileptic drugs in patients with low grade and anaplastic glioma after long-term seizure freedom: a prospective observational study.
Observational study in Journal of neuro-oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Palliative care and end-of-life care in adults with malignant brain tumors.Neuro-oncology · 2023Pooled it
- Brain Tumor Related Epilepsy: Pathophysiology and Multimodal Approach to Management.Current oncology reports · 2025Review
- Long-Term Follow-Up Results of Antiseizure Medication Withdrawal in Grade 2 and 3 Glioma Patients: A Prospective Observational Study.Neurology · 2025Observational
- Study protocol of short versus long-term levetiracetam in brain tumors (LIBRA): a phase 3 randomized controlled trial.BMC cancer · 2025Article
- Brain tumors and fitness to drive: A review and multi-disciplinary approach.Neuro-oncology practice · 2025Review
- Symptom management in isocitrate dehydrogenase mutant glioma.Neuro-oncology practice · 2025Review
- Patient-Centered Management of Brain Tumor-Related Epilepsy.Current neurology and neuroscience reports · 2024Review
- Brain tumor-related epilepsy management: A Society for Neuro-oncology (SNO) consensus review on current management.Neuro-oncology · 2024Review
- Brain tumor-related epilepsy: an overview on neuropsychological, behavioral, and quality of life issues and assessment methodology.Frontiers in neurology · 2024Review
- Impact of timing of antiseizure medication withdrawal on seizure recurrence in glioma patients: a retrospective observational study.Journal of neuro-oncology · 2023Observational
- Seizure Management and Prophylaxis Considerations in Patients with Brain Tumors.Current oncology reports · 2023Review
- Brain Tumor Rehabilitation: Symptoms, Complications, and Treatment Strategy.Brain & NeuroRehabilitation · 2022Review
- Brain tumor related epilepsy: pathophysiological approaches and rational management of antiseizure medication.Neurological research and practice · 2022Review
- Prescription preferences of antiepileptic drugs in brain tumor patients: An international survey among EANO members.Neuro-oncology practice · 2022Article
- Epilepsy treatment in neuro-oncology: A rationale for drug choice in common clinical scenarios.Frontiers in pharmacology · 2022Review
- Efficacy of antiepileptic drugs in glioma patients with epilepsy: a systematic review.Neuro-oncology practice · 2021Review
- Medical and Neurological Management of Brain Tumor Complications.Current neurology and neuroscience reports · 2021Review
- The Korean Society for Neuro-Oncology (KSNO) Guideline for Antiepileptic Drug Usage of Brain Tumor: Version 2021.1.Brain tumor research and treatment · 2021Article
- Seizures, Edema, Thrombosis, and Hemorrhages: An Update Review on the Medical Management of Gliomas.Frontiers in oncology · 2021Review
- Neurological and Medical Complications in Brain Tumor Patients.Current neurology and neuroscience reports · 2020Review
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhen glioma patients experience long-term seizure freedom the question arises whether antiepileptic drugs (AEDs) should be continued. As no prospective studies exist on seizure recurrence in glioma patients after AED withdrawal, we evaluated the decision-making process to withdraw AEDs in glioma patients, and seizure outcome after withdrawal.
methodsPatients with a histologically confirmed low grade or anaplastic glioma were included. Eligible patients were seizure free ≥ 1 year from the date of last antitumor treatment, or ≥ 2 years since the last seizure when seizures occurred after the end of the last antitumor treatment. Patients and neuro-oncologists made a shared decision on the preferred AED treatment (i.e. AED withdrawal or continuation). Primary outcomes were: (1) outcome of the shared decision-making process and (2) rate of seizure recurrence.
resultsEighty-three patients fulfilled all eligibility criteria. However, in 12/83 (14%) patients, the neuro-oncologist had serious objections to AED withdrawal. Therefore, 71/83 (86%) patients were analyzed; In 46/71 (65%) patients it was decided to withdraw AED treatment. In the withdrawal group, 26% (12/46) had seizure recurrence during follow-up. Seven of these 12 patients (58%) had tumor progression, of which three within 3 months after seizure recurrence. In the AED continuation group, 8% (2/25) of patients had seizure recurrence of which one had tumor progression.
conclusionIn 65% of patients a shared decision was made to withdraw AEDs, of which 26% had seizure recurrence. AED withdrawal should only be considered in carefully selected patients with a presumed low risk of tumor progression.
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