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Seizures in patients with primary and metastatic brain tumors

Jan Drappatz, MD
Patrick Y Wen, MD
Edward K Avila, DO
Section Editors
Timothy A Pedley, MD
Lisa M DeAngelis, MD, FAAN, FANA
Deputy Editor
Janet L Wilterdink, MD


Seizures are a common and potentially devastating complication of both primary and metastatic brain tumors [1]. Such seizures are focal in origin and may either remain focal or secondarily generalize. The diagnosis of a seizure disorder is usually made clinically.

The epidemiology and treatment of seizures, prophylactic use of antiseizure drugs, and complications of therapy in patients with brain tumors will be reviewed here. The clinical manifestations of brain tumors and the general management of seizures are discussed elsewhere. (See "Overview of the clinical features and diagnosis of brain tumors in adults", section on 'Clinical manifestations' and "Overview of the management of epilepsy in adults".)


Seizures are a relatively common problem in patients with brain tumors. Seizures may be the initial manifestation of a brain tumor or may occur during the course of disease. (See "Overview of the clinical features and diagnosis of brain tumors in adults", section on 'Seizures'.)

The main factors that influence the incidence of seizures are tumor type, grade, and location:

Among patients with primary brain tumors, seizures are more common with low-grade tumors than with high-grade tumors [2]. The prevalence rates of epilepsy in a series of 1028 patients with primary brain tumors were 85, 69, and 49 percent among patients with low-grade glioma, anaplastic glioma, and glioblastoma, respectively [3]. Other studies have found that at least one seizure occurs in up to 80 percent in patients with high-grade glioma at some time during the course of disease [4].

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Literature review current through: Nov 2017. | This topic last updated: Jun 28, 2017.
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