脑肿瘤相关癫痫是一种异质性综合征，涉及不同脑肿瘤病理中癫痫发作的发病率、时间、病理生理学和临床危险因素的变异性。癫痫风险和残疾在疾病过程中是动态的，并受到肿瘤定向治疗的影响，需要采取以患者为中心的个体化管理策略来优化生活质量。最近弥漫性神经胶质瘤的转化研究结果表明神经胶质瘤生长和过度兴奋之间存在动态的双向关系。某些超兴奋性的非侵入性测量与生存结果相关，但如何随着时间的推移连续定义和测量临床相关的超兴奋性仍不确定。切除范围、术前和/或术后癫痫发作的时间以及肿瘤进展的可能性是影响癫痫复发风险的关键因素。较新的抗癫痫药物在该人群中通常具有良好的耐受性和相似的功效，并且几种快速起效的癫痫救援药物正在开发中并可供使用。脑肿瘤患者的癫痫发作很大程度上受到潜在肿瘤生物学和治疗的影响。更好地了解肿瘤细胞与过度兴奋之间的相互作用将有助于靶向治疗。对癫痫发作的多学科管理应考虑肿瘤定向治疗和预后，并根据患者的个人优先事项和生活质量制定抗癫痫药物决策。© 2024。这是美国政府的作品，不受版权保护在美国的保护；外国版权保护可能适用。

Brain tumor-related epilepsy is a heterogenous syndrome involving variability in incidence, timing, pathophysiology, and clinical risk factors for seizures across different brain tumor pathologies. Seizure risk and disability are dynamic over the course of disease and influenced by tumor-directed treatments, necessitating individualized patient-centered management strategies to optimize quality of life.Recent translational findings in diffuse gliomas indicate a dynamic bidirectional relationship between glioma growth and hyperexcitability. Certain non-invasive measures of hyperexcitability are correlated with survival outcomes, however it remains uncertain how to define and measure clinically relevant hyperexcitability serially over time. The extent of resection, timing of pre-operative and/or post-operative seizures, and the likelihood of tumor progression are critical factors impacting the risk of seizure recurrence. Newer anti-seizure medications are generally well-tolerated with similar efficacy in this population, and several rapid-onset seizure rescue agents are in development and available. Seizures in patients with brain tumors are strongly influenced by the underlying tumor biology and treatment. An improved understanding of the interactions between tumor cells and the spectrum of hyperexcitability will facilitate targeted therapies. Multidisciplinary management of seizures should occur with consideration of tumor-directed therapy and prognosis, and anti-seizure medication decision-making tailored to the individual priorities and quality of life of the patient.© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.