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Withdrawal of antiepileptic drugs in glioma patients after long-term seizure freedom: design of a prospective observational study

Overview of attention for article published in BMC Neurology, August 2014
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Title
Withdrawal of antiepileptic drugs in glioma patients after long-term seizure freedom: design of a prospective observational study
Published in
BMC Neurology, August 2014
DOI 10.1186/s12883-014-0157-4
Pubmed ID
Authors

Johan A F Koekkoek, Melissa Kerkhof, Linda Dirven, Jan J Heimans, Tjeerd J Postma, Maaike J Vos, Jacoline E C Bromberg, Martin J van den Bent, Jaap C Reijneveld, Martin J B Taphoorn

Abstract

BackgroundEpilepsy is common in patients with a glioma. Antiepileptic drugs (AEDs) are the mainstay of epilepsy treatment, but may cause side effects and may negatively impact neurocognitive functioning and quality of life. Besides antiepileptic drugs, anti-tumour treatment, which currently consists of surgery, radiotherapy and/or chemotherapy, may contribute to seizure control as well. In glioma patients with seizure freedom after anti-tumour therapy the question emerges whether AEDs should be continued, particularly in the case where anti-tumour treatment has been successful. We propose to explore the possibility of AED withdrawal in glioma patients with long-term seizure freedom after anti-tumour therapy and without signs of tumour progression.Methods/designWe initiate a prospective, observational study exploring the decision-making process on the withdrawal or continuation of AEDs in low-grade and anaplastic glioma patients with stable disease and prolonged seizure freedom after anti-tumour treatment, and the effects of AED withdrawal or continuation on seizure freedom. We recruit participants through the outpatient clinics of three tertiary referral centers for brain tumour patients in The Netherlands. The patient and the treating physician make a shared decision to either withdraw or continue AED treatment. Over a one-year period, we aim to include 100 glioma patients. We expect approximately half of the participants to be willing to withdraw AEDs. The primary outcome measures are: 1) the outcome of the shared-decision making on AED withdrawal or continuation, and decision related arguments, and 2) seizure freedom at 12 months and 24 months of follow-up. We will also evaluate seizure type and frequency in case of seizure recurrence, as well as neurological symptoms, adverse effects related to AED treatment or withdrawal, other anti-tumour treatments and tumour progression.DiscussionThis study addresses two issues that are currently unexplored. First, it will explore the willingness to withdraw AEDs in glioma patients, and second, it will assess the risk of seizure recurrence in case AEDs are withdrawn in this specific patient population. This study aims to contribute to a more tailored AED treatment, and prevent unnecessary and potentially harmful use of AEDs in glioma patients.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 83 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Netherlands 1 1%
Unknown 82 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 14 17%
Student > Ph. D. Student 11 13%
Student > Doctoral Student 9 11%
Researcher 9 11%
Student > Bachelor 7 8%
Other 14 17%
Unknown 19 23%
Readers by discipline Count As %
Medicine and Dentistry 42 51%
Nursing and Health Professions 3 4%
Neuroscience 3 4%
Mathematics 2 2%
Economics, Econometrics and Finance 2 2%
Other 5 6%
Unknown 26 31%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 August 2014.
All research outputs
#15,303,896
of 22,760,687 outputs
Outputs from BMC Neurology
#1,479
of 2,428 outputs
Outputs of similar age
#133,435
of 230,675 outputs
Outputs of similar age from BMC Neurology
#22
of 42 outputs
Altmetric has tracked 22,760,687 research outputs across all sources so far. This one is in the 22nd percentile – i.e., 22% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,428 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.7. This one is in the 26th percentile – i.e., 26% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 230,675 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 32nd percentile – i.e., 32% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 42 others from the same source and published within six weeks on either side of this one. This one is in the 40th percentile – i.e., 40% of its contemporaries scored the same or lower than it.