The diagnosis of a brain tumor requires healthcare providers to examine the best course of treatment for each individual patient. Unfortunately, seizures are a common occurrence in those with brain tumors. Seizures can contribute to many undesirable life-altering consequences that can greatly impact quality of life. Healthcare providers are inconsistent in the use of prophylactic antiepileptic drugs. Despite published guidelines, prophylactic use of antiepileptic drugs is still practiced for patients who have never experienced a seizure. Because of the many side effects of first-generation antiepileptic drugs, this practice should be discouraged. Furthermore, drug interactions between antiepileptic drugs and antineoplastic treatments can cause life-threatening complications. Since the 1990s, newer antiepileptic drugs, which have fewer drug interactions, have been introduced and show promise as first-line therapy and adjunct treatment of epilepsy. Although reports have demonstrated their promise, prospective randomized controlled trials are needed to determine their reliability in this population of patients. Managing seizures in brain tumor patients requires diligent comprehensive care by healthcare providers to help limit unnecessary side effects and improve quality of life.