Brain Tumour – ASM Choice — SCE Neurology MCQ

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ModerateEpilepsy & Seizure DisordersBrain Tumour – ASM ChoiceSCE Neurology

A 55-year-old woman with a right frontal glioma is started on levetiracetam for seizures. She is also on dexamethasone and will receive temozolomide. Which ASM is specifically avoided in brain tumour patients because of enzyme induction?

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Correct answer: B — Phenytoin

Explanation lettering: C = shown as B · E = shown as C · B = shown as D · D = shown as E

Enzyme-inducing ASMs (phenytoin, carbamazepine, phenobarbital) are avoided in brain tumour patients as they accelerate metabolism of chemotherapy and steroids. Non-enzyme-inducing ASMs (levetiracetam, lamotrigine, lacosamide, brivaracetam) are preferred. A/B/D/E: All are non-enzyme-inducing.

Reference: NICE NG99 (2021)