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Evidence summaries

Antiepileptic Drugs for Preventing Seizures in People with Brain Tumours

Antiepileptic drugs phenytoin, phenobarbital or divalproex may not be effective in preventing postoperative seizures in patients with brain tumours. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 5 studies with a total of 440 subjects with brain tumours. The antiepileptic drugs examined were phenytoin, phenobarbital, and divalproex sodium. There was no difference between the treatment and control groups in preventing a first seizure (RR 0.94, 95% CI 0.55 to 1.61). The risk of an adverse event was higher for those on antiepileptic drugs than for participants not on antiepileptic drugs (NNH 3; RR 6.10, 95% CI 1.10 to 34.63).

Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in interventions and outcomes) and by limitations in study quality (inadequate or unclear allocation concealment).

    References

    • Tremont-Lukats IW, Ratilal BO, Armstrong T, Gilbert MR. Antiepileptic drugs for preventing seizures in people with brain tumors. Cochrane Database Syst Rev 2008 Apr 16;(2):CD004424. [PubMed]

Primary/Secondary Keywords