title: Levetiracetam compared to phenytoin for the prevention of postoperative seizures after craniotomy for intracranial tumours in patients without epilepsy.
abstract: Anticonvulsant drugs are frequently given after craniotomy. Phenytoin (PHT) is the most commonly used agent; levetiracetam (LEV) is a new anticonvulsant drug with fewer side effects. To compare the incidence of seizures in patients receiving either prophylactic PHT or LEV perioperatively, 971 patients undergoing a craniotomy were analysed retrospectively during a 2-year period. PHT was used routinely and LEV was administered when PHT was contraindicated. Seizures documented during the first 7 days after craniotomy were considered. A total of 235 patients were treated with an antiepileptic drug: 81 patients received LEV, and 154 patients, PHT. Two patients receiving LEV (2.5%) and seven receiving PHT (4.5%) had a seizure despite this treatment. No patient had a documented side effect or drug interaction. The data show that LEV may be an alternative option in patients with contraindications to PHT.
authors: Department of Neurosurgery, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, Regensburg 93053, Germany.
authors: K
authors: K
authors: Kern
authors: K M
authors: KM
authors: Schebesch
authors: J
authors: J
authors: Schlaier
authors: E
authors: E
authors: Hansen
authors: G C
authors: GC
authors: Feigl
authors: A T
authors: AT
authors: Brawanski
authors: M
authors: M
authors: Lange
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D002648:Child; D000075202:Contraindications; D003399:Craniotomy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D008875:Middle Aged; D010672:Phenytoin / Q000494:pharmacology* / Q000627:therapeutic use; D010889:Piracetam / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D011183:Postoperative Complications / Q000188:drug therapy* / Q000517:prevention & control; D012189:Retrospective Studies; D012640:Seizures / Q000188:drug therapy* / Q000517:prevention & control; D055815:Young Adult
chemical_list: D000077287:Levetiracetam; D010672:Phenytoin; D010889:Piracetam