This chapter addresses the topic of brain tumors as causes of epilepsy. It focuses on secondary brain tumors, commonly referred to as solid metastatic brain tumors, and neoplastic meningitis. Epileptic seizures in patients with cerebral metastatic disease are most likely multifactorial, however, a number of factors are considered to be contributing to the development and continuation of these seizures in a subgroup of individuals. Antiepileptic drugs are known to reduce the activity of chemotherapeutic drugs. The treatment of epilepsy in patients with secondary brain tumors should involve a multidisciplinary team that is knowledgeable about all the surgical, radiation, and therapeutic options in the management of these patients. Research needs to be focused on the best antiepileptic drug (AED) or drug combination to use in these patients so that new practice guidelines can be developed to improve patient care.

This chapter reviews the characteristics of the various interactions between the various antiepileptic drugs (AEDs), including those that are in development and what is presently known regarding their mechanism. It highlights the benefits this knowledge can offer to optimize the treatment for each type of epilepsy in children. A number of AEDs have been shown to be effective as monotherapy for various types of epilepsy, in which they may therefore be administered as first-line drug. In infancy, Dravet syndrome may worsen with the addition of carbamazepine (CBZ), phenobarbital (PB), lamotrigine (LTG), or vigabatrin (VGB). The coadministration of AED and chemotherapeutic drugs (CTD) may lead either to reduced activity or increased toxicity of an AED. Although the rule of monotherapy as the strategy of choice clearly applies to the majority of pediatric patients suffering from epilepsy, it remains difficult to maintain it for patients with pharmacoresistant epilepsy.