Postoperative Seizures : Epidemiology, Pathology, and Prophylaxis

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概要

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• The risk of epileptic seizures after craniotomy is extremely important but the incidence of postoperative epilepsy varies greatly, depending on the patient's conditions such as primary diseases, severity of surgical insult, and pre-existing epilepsy. Animal studies suggest that neurosurgical insults lead to seizures by two different mechanisms: One mechanism is mediated by free radical generation and the other by impaired ion balance across the cell membrane caused by ischemia or hypoxia. Conventional antiepileptic agents such as phenytoin, phenobarbital, carbamazepine, and valproic acid are promising for the prevention of early seizures, but the effect in preventing postoperative epilepsy is still controversial. Studies on the prophylactic effect of newer antiepileptic agents in craniotomized patients were very limited. Zonisamide, an antiepileptic agent with antiepileptogenic, free radical scavenging and neuroprotective actions in experimental animals, showed promising effects against postoperative epilepsy in a randomized double blind controlled trial. Prophylactic treatment for craniotomized patients significantly prevented the development of partial seizures during the follow-up period. Most recent studies have not supported the prophylactic use of antiepileptic agents in craniotomized patients, but further studies are required.

• 日本脳神経外科学会の論文
• 2003-12-15

著者

• Ishijima Buichi

  Shin-tokorozawa Seiwa Hospital Seiwakai Incorporated Medical Institution

• Manaka Shinya

  Manaka Hospital

• Mayanagi Yoshiaki

  Department Of Neurological Surgery Central Hospital Of Japanese National Rialways

関連論文

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• Symposium II : Ictal SPECT in Temporal and Extratemporal Epilepsy
• Focus Diagnosis of Epilepsy Using Near-Infrared Spectroscopy
• 2. Studies on Cytodiagnosis for Neoplasms of the Central Nervors System (Proceedings of the XXVth Annual Meeting of the Japan Neurosurgical Society)
• Postoperative Seizures : Epidemiology, Pathology, and Prophylaxis

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