{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:48:50Z","timestamp":1783576130408,"version":"3.55.0"},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Although seizures are a relatively common phenomenon in the setting of brain metastases (BMs), there are no discrete recommendations regarding the use of antiepileptic drugs (AEDs) in this population, either in general or in the context of treatment. The authors\u2019 aim was to better understand the underlying pathological factors as well as the therapeutic techniques that may lead to seizures following the radiosurgical treatment of BMs with the goal of guiding appropriate AED prophylaxis.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Adult patients with BMs diagnosed from 2013 to 2020 at a single academic institution and treated with radiation therapy were included in this study. The authors evaluated factors associated with the incidence of seizures throughout the disease course, with a focus on seizures in the 90-day period following stereotactic radiosurgery (SRS).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Four hundred forty-four patients with newly diagnosed BMs were identified, 10% of whom had seizures at the time of presentation and 28% of whom had a seizure at any point during the study period. Tumor histology was significantly associated with initial seizure risk. AED use was highly variable. In the 90-day post-SRS period, the summed total planning target volume (PTV) was independently predictive of post-SRS seizures, regardless of the fractionation scheme (single fraction vs hypofractionated) and other clinical factors. The number of supratentorial BMs was not predictive of post-SRS seizures.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>PTV is a superior predictor of post-SRS seizures relative to the number of supratentorial BMs, as it serves as a volumetric proxy for intracranial disease burden. A larger PTV, alongside tumor histology and prior seizure history, should be considered in the decision-making process for AED use following radiosurgery.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.2.jns222778","type":"journal-article","created":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:18:15Z","timestamp":1680308295000},"page":"925-933","source":"Crossref","is-referenced-by-count":4,"title":["Seizure outcomes following single-fraction versus hypofractionated radiosurgery for brain metastases: a single-center experience"],"prefix":"10.3171","volume":"139","author":[{"given":"Michelle Shizu","family":"Miller","sequence":"first","affiliation":[{"name":"David Geffen School of Medicine, University of California, Los Angeles, California;"},{"name":"Department of Neurosurgery, Tulane University School of Medicine, New Orleans, Louisiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won","family":"Kim","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine, University of California, Los Angeles, California;"},{"name":"Departments of Neurosurgery and"},{"name":"Radiation Oncology, University of California, Los Angeles, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Harary","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricky R.","family":"Savjani","sequence":"additional","affiliation":[{"name":"Radiation Oncology, University of California, Los Angeles, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Lee","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine, University of California, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donatello","family":"Telesca","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Tenn","sequence":"additional","affiliation":[{"name":"Radiation Oncology, University of California, Los Angeles, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Hegde","sequence":"additional","affiliation":[{"name":"Radiation Oncology, University of California, Los Angeles, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Kaprealian","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Radiation Oncology, University of California, Los Angeles, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"11","key":"b1","series-title":"Neuro Oncol","first-page":"1511","article-title":"Incidence and prognosis of patients with brain metastases at diagnosis of systemic malignancy: a population-based study","volume":"19","author":"Cagney DN","year":"2017","unstructured":"Cagney DN, Martin AM, Catalano PJ,  Incidence and prognosis of patients with brain metastases at diagnosis of systemic malignancy: a population-based study. 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