Эпилепсия у больных с глиобластомой: механизмы возникновения и проблемы лечения (часть 1)

Эпилепсия, вызванная глиобластомой, требует внимательного изучения комбинации вызывающих ее факторов с комплексным подходом к профилактике и полному купированию при возникновении таких припадков. Основные взаимосвязанные вопросы должны быть рассмотрены при лечении эпилептических припадков у пациентов с глиобластомой. Контроль над судорогами часто требует введения противоэпилептических препаратов одновременно с другими видами лечения, включающими хирургию, лучевую и химиотерапию. Фармакологические взаимодействия между противоэпилептическими препаратами и антинеопластическими агентами могут изменять активность обоих методов лечения, снижая их эффективность и увеличивая вероятность развития комплекса побочных эффектов, связанного с обеими терапиями. Представленный литературный обзор резюмирует новые патофизиологические пути, связанные с глиобластомой и участвующие в эпилептогенезе, а также описывает взаимодействие между противоэпилептическими препаратами и онкологическим лечением. В статье уделяется особое внимание влиянию лечения на выживание, представлены доказательства эффективности противоэпилептического лечения, включая потенциальную полезность новых противоэпилептических препаратов третьего поколения.

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