title: Prophylactic Antiepileptic Drug Use in Patients with Brain Tumors Undergoing Craniotomy.
abstract: BACKGROUND
  Prophylactic use of antiepileptic drugs (AEDs) for patients undergoing brain tumor surgery is common practice despite lack of clear evidence. We hypothesized that prophylactic AED (pAED) use did not affect seizure rates in patients with brain tumor who underwent craniotomy for tumor resection.
  
  
  METHODS
  A retrospective review was performed of 606 patients who underwent surgery for brain tumors from 2006 to 2013 at the University of Florida, excluding patients with preexisting seizure condition before tumor diagnosis. Data were analyzed to determine seizure incidence, AED use, and AED toxicities.
  
  
  RESULTS
  Most patients (81%) had no seizure on presentation. Eight patients did not present with seizure but had seizure postoperatively, and 9 patients did not present with seizure or have seizure postoperatively but did have seizure on follow-up. Despite not presenting with a seizure preoperatively, 208 patients (43%) were placed on pAED preoperatively, 313 patients (64%) were on AED in the postoperative period, and 274 patients (56%) remained on AED at discharge. The pAED use odds ratio for seizures was 1.3 (95% confidence interval, 0.5-3.4; P = 0.599). At last follow-up, 34% of patients with no seizure on presentation remained on pAEDs.
  
  
  CONCLUSIONS
  pAEDs did not significantly reduce postoperative seizures in patients with brain tumor in this analysis. In addition, pAED was often continued once prescribed even if the patient remained seizure free.
authors: Department of Neurosurgery, University of Florida, Gainesville, Florida, USA. Electronic address: lockney@ufl.edu.
authors: Dennis T
authors: DT
authors: Lockney
authors: Department of Neurosurgery, University of Florida, Gainesville, Florida, USA.
authors: Sasha
authors: S
authors: Vaziri
authors: Department of Neurosurgery, University of Florida, Gainesville, Florida, USA.
authors: Frank
authors: F
authors: Walch
authors: Department of Neurosurgery, University of Florida, Gainesville, Florida, USA; Department of Biostatistics, University of Florida, Gainesville, Florida, USA.
authors: Paul
authors: P
authors: Kubilis
authors: Department of Neurosurgery, University of Florida, Gainesville, Florida, USA; Department of Biostatistics, University of Florida, Gainesville, Florida, USA.
authors: Dan
authors: D
authors: Neal
authors: Department of Neurosurgery, University of Florida, Gainesville, Florida, USA.
authors: Gregory J A
authors: GJ
authors: Murad
authors: Department of Neurosurgery, University of Florida, Gainesville, Florida, USA.
authors: Maryam
authors: M
authors: Rahman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003399:Craniotomy / Q000009:adverse effects*; D004827:Epilepsy / Q000209:etiology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: Antiepileptic therapy; Brain tumor; Seizure prophylaxis