gms | German Medical Science

64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

Value of anticonvulsant prophylaxis in the prevention of perioperative seizures in patients with intra-axial brain tumors

Meeting Abstract

  • Marco Skardelly - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • Elina Brendle - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • Susan Noell - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • Constantin Roder - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • Marcos Tatagiba - Klinik für Neurochirurgie, Universitätsklinikum Tübingen

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocMO.05.08

doi: 10.3205/13dgnc045, urn:nbn:de:0183-13dgnc0457

Published: May 21, 2013

© 2013 Skardelly et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: The application of prophylactic anticonvulsant medications is not effective in the prevention of first seizures in brain tumor patients. Due to the lack of efficacy of seizure prevention and the potential side effects of long-term anticonvulsant therapy, the routine use of medical anticonvulsant prophylaxis of newly diagnosed brain tumors is not recommended nowadays. Although there is also no evidence for the efficacy of perioperative anticonvulsant prophylaxis, it is very commonly used by neurosurgeons. In this study, we investigated the risk of developing post-operative seizures for brain tumor patients with or without an anticonvulsant medication.

Method: A retrospective analysis was performed to find out the incidence of postoperative seizures at our institution in patients with intra-axial brain tumors, who underwent surgical procedures between 01-2009 and 10-2012. Patients, who presented with a history of a seizure before operation, were excluded from the analysis.

Results: 651 patients were operated, of which 165 (25%) presented with a history of at least one seizure. Therefore 486 patients were included. 3,9% (15/383) with no anticonvulsant prophylaxis and 7,8% (8/103) on anti-epileptic medication developed a first post-operative seizure within one week after surgery. Patients under peri-operative anticonvulsant medication in our cohort demonstrated a higher incidence of developing a postoperative seizure rather than a reduction (Odds ratio: 2,006; 95%-confidence interval: 0.8506 to 5.018), which was not statistically significant (p=0,1168).

Conclusions: Our results show that perioperative anticonvulsant prophylaxis is not effective in preventing post-operative seizures. The observed higher incidence of postoperative seizures in patients on anti-epileptic medication is likely due to a preoperative (ambulant) selection bias. Therefore we cannot recommend an overall application of peri-operative anti-epileptics in brain tumor surgery.