Skip Navigation LinksHome > February 2010 - Volume 42 - Issue 1 > The Management of Seizures in Brain Tumor Patients
Journal of Neuroscience Nursing:
doi: 10.1097/JNN.0b013e3181cdb3fb
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The Management of Seizures in Brain Tumor Patients

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GENERAL PURPOSE STATEMENT: To provide registered professional nurses with current guidelines and research findings on the use of antiepileptic drugs (AEDs) and the risk of seizures in brain tumor patients.

LEARNING OBJECTIVES: After reading the article and taking this test, the nurse should be able to:

1. Describe seizure risk for brain tumor patients and recommended use of prophylactic AEDs.

2. Discuss drug therapy with AEDs and its complications.

3. Discuss research findings and their implications for management of the patient.

1. Compared to high-grade gliomas, the risk of seizures in low-grade gliomas is

a. negligible.

b. significantly lower.

c. about the same.

d. higher.

2. Patients with high-grade gliomas often have seizures triggered by

a. neuronal components.

b. remote cell changes.

c. cellular changes.

d. complications of treatment.

3. Tumors located in which area of the brain will most commonly generate seizures?

a. pituitary

b. infratentorial

c. cortical gray matter

d. deep cerebral white matter

4. The American Academy of Neurology (AAN) recommends that after tumor resection, antiepileptic drugs (AEDs) should be

a. discontinued within 2 days after surgery.

b. tapered and discontinued after the first postoperative week.

c. prescribed for at least the first month following surgery.

d. continued indefinitely for prophylaxis.

5. For brain tumor patients with no history of epilepsy, the AAN recommends that

a. AEDs not be used.

b. AEDs be used on a short-term basis.

c. the individual neurologist determine whether AED use is needed.

d. long-term AEDs be prescribed.

6. The Mayo Foundation for Medical Education and Research's 2004 systematic review of three common AEDs for seizure prophylaxis showed

a. no statistical benefit.

b. inconsistent data.

c. statistical benefit only for specific types of brain tumors.

d. overall significant statistical benefit for all brain tumors.

7. Which percentage of surveyed members of the American Association of Neurological Surgeons prescribe prophylactic AEDs to certain brain tumor patients?

a. 10%

b. 30%

c. 50%

d. 70%

8. The Glioma Outcomes Project revealed that for glioma patients without seizures, prophylactic AEDs are

a. a necessary part of therapy.

b. effective at preventing status epilepticus.

c. ordered by the majority of physicians.

d. indicated when the patient has brain metastasis.

9. For brain tumor patients who have experienced a seizure, universal conformity is observed by physicians in

a. avoiding prescribed AEDs.

b. prescribing long-term AEDs.

c. prescribing combination AEDs.

d. prescribing only older generation AEDs.

10. A 2004 report by the AAN and American Epilepsy Society recommended that new onset epileptic patients initially receive

a. monotherapy using only a newer AED.

b. monotherapy using only an older AED.

c. monotherapy with either an older or newer AED.

d. one older and one newer AED used in combination.

11. Which AED can decrease the clearance of other drugs that use the CYP-450 pathway?

a. carbamazepine

b. oxcarbazepine

c. phenytoin

d. valproate

12. When dexamethasone is combined with phenytoin,

a. lower doses of phenytoin are needed.

b. toxic levels of dexamethasone may result.

c. frequent phenytoin level monitoring is required.

d. dexamethasone doses should be reduced.

13. Symptoms of phenytoin toxicity include all of the following except

a. hyperactivity.

b. dizziness.

c. diplopia.

d. severe skin reactions.

14. Alternative therapies that are epileptogenic include all except

a. ginseng.

b. ginko.

c. St. John's wort.

d. ephedra.

15. Patients with brain tumors may be at higher risk of osteoporosis for all of the following reasons except

a. AEDs aid the process of osteoporosis.

b. birth control pills with AEDs slow calcium absorption.

c. concurrent steroid therapy promotes osteoporosis.

d. AEDs alter vitamin D metabolism.

16. Several studies show seizure reduction with use of which second generation AED?

a. levetiracetam

b. gabapentin

c. felbamate

d. zonisamide

17. Patients should be taught to avoid the most common seizure-triggering factors, which include all the following except

a. tiredness.

b. alcohol consumption.

c. sleep deprivation.

d. emotional stress.

18. Which AED has proven anxiolytic properties?

a. phenobarbital

b. lamotrigine

c. topiramate

d. gabapentin

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© 2010 American Association of Neuroscience Nurses


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