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Seizures Following Intracranial Surgery: Incidence in the First Post-Operative Week

Published online by Cambridge University Press:  18 September 2015

E. Matthew ,
A.L. Sherwin ,
S.A. Welner ,
K. Odusote  and
J.G. Stratford
E. Matthew
Affiliation:
Department of Neurology and Neurosurgery, McGill University, Montreal General Hospital, and Montreal Neurological Institute
A.L. Sherwin*
Affiliation:
Department of Neurology and Neurosurgery, McGill University, Montreal General Hospital, and Montreal Neurological Institute
S.A. Welner
Affiliation:
Department of Neurology and Neurosurgery, McGill University, Montreal General Hospital, and Montreal Neurological Institute
K. Odusote
Affiliation:
Department of Neurology and Neurosurgery, McGill University, Montreal General Hospital, and Montreal Neurological Institute
J.G. Stratford
Affiliation:
Department of Neurology and Neurosurgery, McGill University, Montreal General Hospital, and Montreal Neurological Institute
*
Montreal Neurological Institute, 3801 University St., Montreal, Quebec, H3A 2B4, Canada
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Consecutive craniotomies (118) drawn from major hospitals, and performed for disorders other than epilepsy or acute trauma were reviewed. The final diagnosis included tumor (70), subdural hematoma (13), aneurysm (10), arteriovenous malformation (7), and miscellaneous lesions (18). Eighty-seven (73.7%) patients had not experienced seizures prior to neurosurgery, II of these (12.6%) had a seizure within the first week, in six the attack occurred within 24 hours, and of these three had further attacks. In contrast, of the 31 patients (26.3%) that had one or more seizures prior to operation, II patients (35.5%) had seizures within the first week. In ten patients seizures occurred within the first 24 hours and of these seven had one or more recurrences later in the week. Anticonvulsant drugs were administered to 72 patients before operation, including all those with a history of seizures, hut loading doses were not utilized to ensure therapeutic levels. In patients with predisposing factors to postoperative seizures, anticonvulsant drugs should be administered before or immediately following craniotomy in adequate dosage to rapidly achieve and maintain effective plasma levels. Phenytoin, owing to its minimal sedative effects is the drug of choice. A loading dose of18 milligrams per kilogram can be safely administered as an admixture to an intravenous infusion of 0.9% saline with careful monitoring of cardiopulmonary function.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 7 , Issue 4 , November 1980 , pp. 285 - 290
Copyright
Copyright © Canadian Neurological Sciences Federation 1980

References

REFERENCES

Andersen, P., Lomo, T. (1969). Organization and frequency dependence of hippo-campal inhibitions. In: Basic Mechanisms of the Epilepsies. Ed. Jasper, H.H., Ward, A.A. and Pope, A.Churchill, London, pp 604–609.Google Scholar
Booker, H.E. (1978). Clinical use and interpretation of serum phenytoin levels. In Antiepileptic Drugs. Qualitative Analysis and Interpretation. Ed. Pippenger, C.E., Penry, J.K., and Kutt, H.Raven Press, New York, pp 253–260.Google Scholar
Cabral, R., King, T.T. and Scott, D.F. (1976). Epilepsy after two different neurosurgical approaches to the treatment of ruptured intracranial aneurysm. J. Neurol. Neurosurg. Psychiatry 39: 1054–1056.CrossRefGoogle Scholar
Cabral, R., King, T.T. and Scott, D.F. (1976). Incidence of post-operative epilepsy after a transtentorial approach to acoustic nerve tumours. J. Neurol. Neurosurg. Psychiatry, 39: 663–665.CrossRefGoogle Scholar
Caveness, W.F. (1976). Epilepsy, a Product of Trauma in our Time. Epilepsia, 17: 207–215.CrossRefGoogle ScholarPubMed
Caveness, W.F., Meirowsky, A.M., Rish, B.L., Mohr, J.P., Kistler, J.P., Dillon, J.D. and Weiss, G.H. (1979). The nature of post-traumatic epilepsy. J. Neurosurg. 50: 545–553.CrossRefGoogle Scholar
Cloyd, J.C., Bosch, D.E. and Sawchuk, R.J. (1978). Concentration-time profile of phenytoin after admixture with small volumes of intravenous fluids. Am. J. Hosp. Pharmacy 35: 45–48.Google ScholarPubMed
Cloyd, J.C., Gumnit, R.J. and McLain, L.W. JR, (1980). Intravenous phenytoin in the management of status epilepticus. J. Amer. Med. Ass. (In Press)CrossRefGoogle Scholar
Cranford, R.E., Leppik, I.E., Patrick, B., Anderson, C.B. and Kostick, B. (1978). Intravenous phenytoin: Clinical and pharmacokinetic aspects. Neurology, 28: 874–880.CrossRefGoogle ScholarPubMed
Cushing, H. and Eisenhardt, L. (1938). Meningiomas. Charles C. Thomas, Springfield, Illinois, pp 875.Google Scholar
Goddard, G.V., Macintyre, D.C. and Leech, C.K. (1969). A permanent change in brain function resulting from daily electrical stimulation. Exptl. Neurol. 25: 295–330.CrossRefGoogle ScholarPubMed
Horwitz, N.H., Rizzoli, H.V. (1967). Postoperative complications in Neurosurgical Practice. The Williams and Wilkins Company, Baltimore, pp 196–198.Google Scholar
Jennett, W.B. (1962). Epilepsy after Blunt Head Injuries. William Heinemann Medical Books, London, pp 150.Google Scholar
Jennett, W.B. (1969). Early traumatic epilepsy. Lancet 1: 1023–1025.CrossRefGoogle ScholarPubMed
Jennett, W.B. (1975). Epilepsy after Non-Missile Head Injuries. William Heinemann Medical Books, Chicago, pp 179.Google Scholar
Jennett, W.B., Lewin, W. (1960). Traumatic Epilepsy after Closed Head Injuries. J. Neurol. Neurosurg. Psychiat. 23: 295–301.CrossRefGoogle ScholarPubMed
Ketz, E. (1974). Brain Tumorand Epilepsy. In: Handbook of Clinical Neurology, Vol. 16. North Holland Publishing Company, Amsterdam.Google Scholar
Northfield, D.W.C. (1973). Head Injury. In: The Surgery of the Central Nervous System. Northfield D.W.C. Blackwell Scientific Publications, Oxford.Google Scholar
Patterson, J.H., McKissock, W.A. (1956). A clinical survey of intracranial angiomas with special reference to their mode of progression and surgical treatment. A report of 110 cases. Brain 79: 233–266.CrossRefGoogle Scholar
Penfield, W.G. and Erickson, T.C. (1941). Epilepsy and Cerebral localisation. Charles C. Thomas, Springfield, Illinois, pp 623.Google Scholar
Penfield, W.G., Jasper, H.H. (1954). Epilepsy and the Functional Anatomy of the Human Brain. Little Brown, Boston, pp 896.Google Scholar
Prior, P.F., Legg, N.J. and Scott, D.F. (1973). Epilepsy following Intracranial Surgery. In: Prevention of Epilepsy and its consequences: Proceeding of the Fifth European Symposium on Epilepsy. Ed. Parsonage, M.J. International Bureau of Epilepsy, London.Google Scholar
Rapport, R.L., Penry, J.K. (1973). A survey of the attitudes towards the pharmacological prophylaxis of post-traumatic epilepsy, J. Neurosurg. 38: 159–166.CrossRefGoogle Scholar
Russell, W.R. (1951). Disability caused by brain woulds. Review of 1166 cases. J. Neurol. Neurosurg. Psychiat. 14: 35–39.CrossRefGoogle Scholar
Wada, J.A., Osawa, T. (1976). Spontaneous recurrent seizure state induced by daily electric amygdaloid stimulation in Senegalese baboons (Papio papio). Neurology, 26: 253–286.CrossRefGoogle ScholarPubMed