Abstract Epilepsy is a common clinical problem in patients with brain tumours, strongly affecting patients’ quality of life. Tumour-related seizures are often dif- ficult to control, and the clinical picture is complicated by frequent interactions between antiepileptic drugs (AEDs) and antineoplastic agents. We studied the safety and efficacy of levetiracetam (LEV), a new AED with a different pharmacological profile from traditional anticonvulsants, in 19 patients (6 females; age range 28–70 years, mean 48 years) with supraten- torial gliomas and epilepsy. Seizure types were simple partial in four patients, complex partial in 4, complex partial with secondary generalization in 7, and gener- alized tonic-clonic in 4. LEV was added to the existing AED treatment on account of persisting seizures, and titrated at dosages of 1,000–3,000 mg/day. Patients were seen at the Outpatient’s Centre every 1–3 months, and followed-up for 7–50 months (mean 25 months, median 20 months). At the end of the observation period, nine patients were seizure free (seizure free period ranging from 7 to 33 months, mean 16, median 12) and five patients reported an improvement in seizure-frequency from daily to weekly (n = 1) or from weekly to monthly (n = 3). Seizure frequency was unmodified in four patients and increased (from monthly to weekly) in one. No LEV- related adverse effects were observed. LEV plasma concentrations monitored in 12 subjects ranged from 11.9 to 82.1 lg/ml. Our preliminary open data indicate that add-on treatment with LEV in patients with brain tumours is safe and appears to be effective in reducing seizure frequency. Controlled studies on larger popu- lations are warranted to confirm these open observa- tions. Keywords AEDs Æ Brain tumours Æ Epilepsy Æ Levetiracetam Æ Side effects Introduction Seizures affect 20–40% of patients with primary brain tumours or brain metastases, with an incidence varying from 15% in patients with glioblastoma to 95% in those with low grade astrocytoma [1, 2]. Seizures sig- nificantly impair patients’ quality of life by increasing anxiety, inducing depression, interfering with driving capacity and professional activities [2, 3]. Epilepsy associated with brain tumours is often unresponsive to treatment [4, 5]. In addition, anticonvulsant treatment in these patients is complicated by pharmacological interactions between antiepileptic drugs (AEDs) and chemotherapeutic agents. These interactions are well documented for ‘‘traditional’’ enzyme-inducing AED, like phenobarbital (PB), phenytoin (PHT), and car- bamazepine (CBZ) [6–9]. The majority of the new AED have a reduced propensity for drug interactions M. Maschio (&) Æ A. Zarabla Æ L. Dinapoli Æ A. Pace Æ A. Pompili Æ C. M. Carapella Æ E. Occhipinti Æ B. Jandolo Department of Neuroscience and Cervical-Facial Pathology, Epilepsy Outpatient’s Centre, ‘‘Regina Elena’’ National Institute for Cancer, Via Elio Chianesi 53, 00144 Rome, Italy e-mail: maschio@ifo.it F. Albani Æ A. Baruzzi Laboratory of Clinical Neuropharmacology, Department of Neurological Sciences, University of Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy J Neurooncol (2006) 80:97–100 DOI 10.1007/s11060-006-9162-9 123 CLINICAL–PATIENT STUDIES Levetiracetam therapy in patients with brain tumour and epilepsy Marta Maschio Æ Fiorenzo Albani Æ Agostino Baruzzi Æ Alessia Zarabla Æ Loredana Dinapoli Æ Andrea Pace Æ Alfredo Pompili Æ Carmine Maria Carapella Æ Emanuele Occhipinti Æ Bruno Jandolo Received: 9 February 2006 / Accepted: 27 March 2006 / Published online: 10 May 2006 Ó Springer Science+Business Media B.V. 2006