A case of castration-resistant metastatic prostate cancer who continued treatment with enzalutamide after epileptic seizure

Abstract

Introduction Enzalutamide is an androgen receptor inhibitor and is used in metastatic castration-resistant prostate cancer. Seizure is a rare side effect of enzalutamide. In this case, the patient had an epileptic seizure while on enzalutamide treatment. His treatment management and and use of enzalutamide afterwards is discussed. Case report A 78-year-old male patient who received previous treatments for metastatic castration-resistant prostate cancer was started on enzalutamide due to progression, and had an epileptic seizure while taking enzalutamide was presented. Different pathologies such as the use of other drugs, brain metastasis, bleeding, electrolyte, liver and kidney disorders that can cause epileptic seizures were explored and not found to be the cause in this patient. No neurological pathology was found in the patient after the seizure. Management and Outcome Enzalutamide and antiepileptic treatment were initiated simultaneously again in the patient whose treatment was interrupted after the seizure and no pathology was found in the brain magnetic resonance imaging. Under this dual treatment, the patient did not have seizures again. Discussion Although observed rarely, enzalutamide-induced epileptic seizure is a known side effect. However, a review of literature did not reveal any report on patients for whom enzalutamide and antiepileptic treatment were initiated and followed up simultaneously after seizures. This case report will contribute to the literature for patients whose treatment options have been exhausted and who may benefit significantly from continued use of enzalutamide despite having a seizure.