Seizure incidence following open craniotomy for brain tumors varies in the literature between 5-27%, and following endoscopic endonasal approach ranges from 0-6.25%. Efficacy of prophylactic anticonvulsant therapy in reducing postoperative seizure rates is inconclusive. Furthermore, there is a paucity of evidence for its role during radiotherapy. The RADIANS clinic, a community hospital-based multidisciplinary central nervous system clinic with radiation oncology and neurosurgery, provides a unique model for continuity of care of patients with brain tumors. Prophylactic levetiracetam (LEV) therapy is provided perioperatively, postoperatively, and during radiotherapy.