title: Results of a survey of neurosurgical practice patterns regarding the prophylactic use of anti-epilepsy drugs in patients with brain tumors.
abstract: BACKGROUND
  The American Association of Neurology issued guidelines discouraging the prophylactic use of anti-epilepsy drugs (AEDs) in patients with brain tumors. We surveyed neurosurgeons to evaluate practice patterns with regard to using AEDs in neurosurgical patients with brain tumors.
  
  
  METHODS
  The survey consisted of 18 questions. Two group email blasts containing an internet link to the survey were sent to members of the American Association of Neurological Surgeons with email addresses. Uni- and multi-variate analysis of the responses was performed using t-test, Fisher's exact test, or chi-squared test, where appropriate.
  
  
  RESULTS
  The response rate was 15.5% (386/2491). The majority of respondents (270/386; 70.0%) had more than 5 years of experience in neurosurgery. Most respondents described their practices as general (224/379; 59.1%); about one-third were members of the Joint Section on Tumors (136/381; 35.7%). More than 70% of respondents reported routine use of AED prophylaxis for patients with intra-axial gliomas or brain metastases. AED prophylaxis was also routinely used for extra-axial benign tumors or stereotactic biopsies by 53.8% and 21.4%, respectively. On multivariate analysis, the number of years in practice of ABNS certified neurosurgeons was the strongest predictor for the use of AED prophylaxis.
  
  
  CONCLUSIONS
  Routine use of AED prophylaxis in patients with brain tumors undergoing neurosurgical procedures remains the prevailing practice pattern among members of the AANS. Additional larger prospective studies with appropriate patient stratification culminating in development of neurosurgical guidelines on AED prophylaxis in brain tumor patients is warranted.
authors.affiliation: Department of Neurosurgery, The Cleveland Clinic Brain Tumor Institute, 9500 Euclid Avenue, ND-40, Cleveland, OH 44195, USA.
authors.forename: Vitaly
authors.initials: V
authors.lastname: Siomin
authors.forename: Lilyana
authors.initials: L
authors.lastname: Angelov
authors.forename: Liang
authors.initials: L
authors.lastname: Li
authors.forename: Michael A
authors.initials: MA
authors.lastname: Vogelbaum
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy*; D004827:Epilepsy / Q000188:drug therapy*; D006306:Health Surveys; D006801:Humans; D019635:Neurosurgical Procedures / Q000639:trends*; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires
chemical_list: D000927:Anticonvulsants