title: Is there any benefit from short-term perioperative antiepileptic prophylaxis in patients with chronic subdural haematoma? A retrospective controlled study.
abstract: BACKGROUND
  Chronic subdural haematoma is a common pathology, which can be complicated by seizures. Seizures may worsen the outcome of patients presenting with a chronic subdural haematoma. However, since the overall and postoperative incidence of seizures and their impact on patients' outcome has been diversely appreciated in the literature, the interest of routine antiepileptic prophylaxis remains a controversial question.
  
  
  METHODS
  We retrospectively investigated 99 patients who were surgically treated for a chronic subdural haematoma in two French academic hospitals: 48 patients received antiepileptic prophylaxis (group A) and were compared with a group of 51 patients who did not receive any antiepileptic prophylaxis (group B). Incidence of perioperative seizures was determined, and potential risk factors for epilepsy were analysed.
  
  
  RESULTS
  Overall postoperative seizure incidence was 5.1%. There was a slight trend towards a lower incidence of seizures in patients who had received antiepileptic prophylaxis, but no significant difference was found between the two groups (4.2% in group A versus 5.9% in group B, P=0.697). Seizures were not correlated with increased death. No risk factor for seizures was identified.
  
  
  CONCLUSIONS
  Our retrospective data showed there is no benefit of perioperative antiepileptic prophylaxis in patients surgically treated for chronic subdural haematoma. Since other authors have shown conflicting results, sufficiently powered prospective randomized study should be conducted in order to confirm these results.
authors.affiliation: Aix-Marseille université, 13284 Marseille, France; Service de neurochirurgie, hôpital Nord, AP-HM, chemin des Bourrely, 13915 Marseille cedex 20, France. Electronic address: fabrice.battaglia@ap-hm.fr.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Battaglia
authors.affiliation: Service de neurochirurgie, CHU de Toulouse, université Paul-Sabatier, 31059 Toulouse, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Plas
authors.affiliation: Aix-Marseille université, 13284 Marseille, France; Service de neurochirurgie, hôpital Nord, AP-HM, chemin des Bourrely, 13915 Marseille cedex 20, France.
authors.forename: Anthony
authors.initials: A
authors.lastname: Melot
authors.affiliation: Aix-Marseille université, 13284 Marseille, France; Service de neurochirurgie, hôpital Nord, AP-HM, chemin des Bourrely, 13915 Marseille cedex 20, France.
authors.forename: Rémy
authors.initials: R
authors.lastname: Noudel
authors.affiliation: Service de neurochirurgie, CHU de Toulouse, université Paul-Sabatier, 31059 Toulouse, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Sol
authors.affiliation: Aix-Marseille université, 13284 Marseille, France; Service de neurochirurgie, hôpital Nord, AP-HM, chemin des Bourrely, 13915 Marseille cedex 20, France.
authors.forename: Pierre-Hugues
authors.initials: PH
authors.lastname: Roche
authors.affiliation: Service de neurochirurgie, CHU de Toulouse, université Paul-Sabatier, 31059 Toulouse, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Lubrano
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use*; D005260:Female; D020200:Hematoma, Subdural, Chronic / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012306:Risk; D012640:Seizures / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*
chemical_list: D000927:Anticonvulsants
keywords: Antiepileptic prophylaxis; Chirurgie; Chronic subdural haematoma; Crises d’épilepsie; Devenir; Epilepsy; Hématome sous-dural chronique; Outcome; Prophylaxie antiépileptique; Seizures; Surgery; Épilepsie