Can a brain tumor worsen seizures despite medication at 42?

Question

Hello doctor,

I am a 42-year-old male diagnosed with epilepsy three years ago after experiencing generalized tonic-clonic seizures. I have been on Levetiracetam 1000 mg twice daily, which helped initially, but over the past few months, my seizures have become more frequent, with three episodes just in the last six weeks.

I have also been having persistent headaches, memory issues, and occasional visual disturbances. An MRI of the brain done last month showed a left temporal lobe lesion suspicious for low-grade glioma, and the neurologist has now referred me to oncology.

My EEG still shows epileptiform discharges in the same region. I am really anxious about how the tumor is affecting my seizure control and whether surgery or radiation will worsen the seizures.

Are there safer anti-seizure medications to use during cancer treatment?
Also, my mood has been worsening since starting Levetiracetam. Could it be from the medication or the tumor itself?
Should I consider switching to Lamotrigine or Valproate?
I am also concerned about driving. Is it still safe, or even allowed, given this recent worsening?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query.

I can really feel how overwhelming this is for you. Dealing with a brain tumor and seizures together is not easy, especially when things do not seem to line up neatly on reports.

Even when an MRI (magnetic resonance imaging) looks stable, it does not always mean everything is completely quiet underneath. With a tumor in the left temporal lobe, the surrounding brain can stay a bit “irritated,” and that alone can trigger more seizures. So if you have been wondering, “Why is this happening if the scan has not changed?” you are not imagining it. This can happen, and it is understandably frustrating.

The EEG (electroencephalogram) showing ongoing abnormal activity just confirms that your brain is still a bit overactive in that area. It does not necessarily mean things are getting worse, but it does mean your seizures need closer attention and possibly some adjustment in treatment.

When it comes to treatment, I know it can feel like every option brings new worries. Surgery, if it is considered safe in your case, can sometimes actually help with seizure (a sudden, uncontrolled electrical disturbance in the brain that alters behavior, movements, feelings, and consciousness) control by removing the source of irritation.

Treatments like radiation (energy emitted as particles or waves, traveling through space or materials) or chemotherapy (a systemic cancer treatment using powerful drugs to kill or slow the growth of rapidly dividing cancer cells throughout the body) can temporarily make seizures flare up a bit due to inflammation, but this is something your team usually anticipates and manages alongside.

Your medications are another important piece of the puzzle. Levetiracetam is commonly used because it works well with cancer treatments, but many people do not realize how much it can affect their mood. Feeling more irritable, low, or emotionally off-balance is a known side effect. On top of that, the temporal lobe itself plays a big role in emotions, so what you are feeling could be coming from both the medication and the tumor’s location.

And just to say this clearly, you do not have to just “push through” those feelings. They matter. There are ways to adjust treatment so you feel more like yourself again, whether that is changing medication, adding mood support, or even just talking it through with someone who understands what this condition does mentally as well as physically.

At this point, it may help to focus on the next few practical steps without overthinking everything at once:

A repeat MRI with contrast can help double-check what is happening at a deeper level
A proper medication review may identify if your current drug is contributing to both seizures and mood changes
Sometimes, a cognitive or psychological assessment helps make sense of memory or emotional changes

About driving, I know this one can feel especially restrictive. But with recent seizures, it is not considered safe right now, and there are also legal guidelines around this. It is frustrating, but it is temporary, and the goal is to get you back to a stable point where it can be reconsidered safely.

One thing to keep in mind going forward is that small, consistent habits do make a difference. Taking medications regularly, getting enough sleep, staying hydrated, and avoiding triggers like sleep deprivation or alcohol can all help reduce seizure frequency more than they may seem.

Also, please do not wait for things to be out if something changes. If seizures become more frequent, come in clusters, or last longer than usual, that is something that needs urgent attention.

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.