title: Incidence and management of late postsurgical seizures in clinical practice.
abstract: OBJECTIVE
  Seizures are a frequent complication in patients who undergo neurosurgery,     and can complicate the post-operative course and deteriorate patients' quality     of life. Evidence on the prophylactic anticonvulsant therapy after craniotomy is     still lacking.
  
  
  METHODS
  We undertook an observational longitudinal     study following neurosurgical supratentorial interventions, to evaluate seizures     onset or persistence, and differences in effectiveness between conventional and     newer AEDs.
  
  
  RESULTS
  A total of 100 consecutive subjects were enrolled. Each     patient underwent a neurosurgical treatment by craniotomy. Pre-operative     seizures occurred in 33% patients, early seizures in 13%. Late seizures occurred     in 46 patients. At baseline (1 month after surgery) and during follow up the     main therapeutic regimen was monotherapy. At last follow up adjustment of     antiepileptic regimen or AED dosage had rendered 27 subjects seizure free.     People taking newer AEDs at baseline maintain the same antiepileptic regimen     more often than patients taking conventional AEDs; late seizures tended to have     a higher incidence in the latter group. Adverse events from baseline AEDs were     reported by 17% of patients.
  
  
  CONCLUSIONS
  In this study population late     postsurgical seizures had a remarkable occurrence. Newer AEDs were continued     more often than conventional AEDs, with a better tolerability but no significant     differences in late seizures incidence.
authors.affiliation: University of Pisa, Department of Neuroscience, Pisa, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Bartolini
authors.forename: Bruno
authors.initials: B
authors.lastname: Lenzi
authors.forename: Riccardo
authors.initials: R
authors.lastname: Vannozzi
authors.forename: Giuliano Francesco
authors.initials: GF
authors.lastname: Parenti
authors.forename: Alfonso
authors.initials: A
authors.lastname: Iudice
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001927:Brain Diseases / Q000601:surgery; D001932:Brain Neoplasms / Q000601:surgery; D015331:Cohort Studies; D003710:Demography; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control*; D011446:Prospective Studies; D012640:Seizures / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants