title: Effectiveness of antiepileptic prophylaxis used with supratentorial craniotomies: a meta-analysis.
abstract: Thirty publications on the effectiveness of prophylactic antiepileptic drugs (AEDs) with supratentorial craniotomies were reviewed (1980-1995). After a first selection, six controlled studies remained (11 publications). These six were evaluated according to previously defined methodological criteria. The criteria were divided into three main categories: (1) internal validity, (2) proper and relevant outcome-measures and (3) analysis. In this way a maximum of 145 points could be obtained for each study. Three studies were considered to be of satisfactory methodological quality (> or = 55% or 145 points) and the odds ratios were calculated as a measure of association between treatment and occurrence of convulsions. The odds ratios of these three studies were statistically pooled using the Mantel-Haenszel Estimator. From this test it appeared that prophylactically used AEDs showed a tendency to prevent postoperative convulsions, but this effect was certainly not statistically significant (P = 0.1 one-tailed). Points of attention concerning possible future investigations are stressed.
authors.affiliation: Department of Neurosurgery, University Hospital Maastricht, The Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: Kuijlen
authors.forename: O P
authors.initials: OP
authors.lastname: Teernstra
authors.forename: A G
authors.initials: AG
authors.lastname: Kessels
authors.forename: M J
authors.initials: MJ
authors.lastname: Herpers
authors.forename: E A
authors.initials: EA
authors.lastname: Beuls
mesh_terms: D001927:Brain Diseases / Q000601:surgery*; D003399:Craniotomy; D004827:Epilepsy / Q000517:prevention & control*; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control*; D011292:Premedication; D015173:Supratentorial Neoplasms / Q000601:surgery*; D016896:Treatment Outcome