Childhood brain and spinal tumours

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Corticosteroids and antiseizure medicines (anticonvulsants)

Corticosteroids and antiseizure medicines (anticonvulsants) are commonly used to treat the symptoms caused by brain and spinal cord tumours and their treatment. They may be used after surgery or during radiation therapy to relieve symptoms. Corticosteroids and antiseizure medicines may be used to treat:

  • swelling of the brain (cerebral edema) or of the spinal cord (spinal edema)
  • headaches or other pain
  • nausea or vomiting
  • fatigue
  • seizures

Your child’s healthcare team will consider your child’s personal needs to plan the drugs, doses and schedules of corticosteroids and antiseizure medicines.

Corticosteroids

A corticosteroid is any steroid hormone that acts as an anti-inflammatory by reducing swelling and lowering the body’s immune response (the immune system’s reaction to the presence of foreign substances). These drugs are used to treat swelling of the brain or spinal cord. Swelling is caused by the tumour growing and pressing on areas of the brain or spinal cord. Normal tissue may also swell as a reaction to surgery or radiation. Swelling in the brain that gets worse can result in a cancer-related emergency referred to as increased intracranial pressure.

Most children with brain or spinal cord tumours will be given corticosteroids to treat or prevent swelling. The most common corticosteroids used are:

  • dexamethasone (Decadron, Dexasone)
  • prednisone
  • methylprednisone (Medrol)

The drug is given at the lowest effective dose for each child and is gradually tapered down and discontinued after the child finishes treatment.

If the edema no longer responds to corticosteroids, mannitol (Osmitrol) may be used.

Side effects

Side effects can happen with any type of treatment for brain and spinal tumours, but every child’s experience is different. If your child develops side effects, they can happen any time during, immediately after or a few days or weeks after therapy.

Side effects of corticosteroids include:

  • infection
  • digestive problems such as nausea, heartburn and stomach irritation or bleeding
  • increased blood sugarlevels
  • frequent urination and increased thirst
  • increased appetite and weight gain
  • trouble sleeping
  • mood changes, restlessness, excitement or nervousness
  • weakness and decrease in muscle size
  • swelling of the face, feet, legs and arms
  • unusual hair growth on the body or face
  • decreased or blurred vision

Tell your child’s healthcare team if your child has these side effects or others. The sooner you tell them of any problems, the sooner they can suggest ways to help your child.

Antiseizure medicines

Many children with brain tumours will have a seizure during their illness.

Antiseizure medicines are given to people with brain tumours who have already had a seizure. Usually, antiseizure medicines are not given to prevent seizures in people who have not had them.

The most common antiseizure drugs used are:

  • phenytoin (Dilantin)
  • carbamazepine (Tegretol)
  • valproate (Depakote)
  • levetiracetam (Keppra)

The level of antiseizure drugs in the blood is checked through regular blood tests. To be safe and effective, the drug level must stay within a certain range.

Side effects

Side effects can happen with any type of treatment for brain and spinal tumours, but every child’s experience is different. If your child develops side effects, they can happen any time during, immediately after or a few days or weeks after therapy.

Side effects of antiseizure medicines include:

  • dizziness
  • drowsiness
  • uncontrolled muscle and eye movements
  • clumsiness
  • nervousness
  • confusion
  • slurred speech
  • nausea or vomiting
  • constipation
  • diarrhea
  • skin rash or itching
  • swollen, painful and bleeding gums
  • headaches
  • blurred or double vision
  • trouble sleeping

Tell your child’s healthcare team if your child has these side effects or others. The sooner you tell them of any problems, the sooner they can suggest ways to help your child.

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