Preventing post-operative seizures in chronic subdural hematoma surgery: role of antiepileptic drugs
DOI:
https://doi.org/10.18203/2349-3259.ijct20251202Keywords:
Chronic subdural hematoma, Anti-epileptic drugs, Post-operative seizures, PhenobarbitoneAbstract
Background: Seizures are a known complication of chronic subdural hematoma (CSDH) and its surgical treatment. While anti-epileptic drugs (AEDs) are often used prophylactically, there is limited evidence of their efficacy in the Bangladeshi population. This study was planned to determine the role of AEDs in preventing postoperative seizures in patients undergoing surgical treatment for CSDH.
Methods: This quasi-experimental study was conducted on 100 patients with CSDH undergoing Burr hole evacuation in the Department of Neuro Surgery at Bangabandhu Sheikh Mujib Medical University (BSMMU) and Dhaka Medical College Hospital (DMCH) from March 2015 to February 2017. Patients were divided into a study group (n=50, no antiepileptics) and a control group (n=50, given Phenobarbitone). Standard postoperative care was provided, with follow-ups on the 1st postoperative day, at discharge (7-10 days), and at 4 weeks. The control group continued Phenobarbitone post-discharge. Seizure occurrence was monitored throughout follow-ups to evaluate the drug's effectiveness in preventing postoperative seizures.
Results: The study population was predominantly male (71.0%), with most participants aged 51-60 years. At baseline, both groups were similar in terms of demography, clinical presentation, and level of consciousness. No preoperative seizure was noted among the study participants. Postoperative seizure incidence was 4.0% among the study group, whereas no one in the control group had developed a seizure. However, no significant difference in postoperative seizure proportion was found between the two groups.
Conclusions: Routine prophylactic use of antiepileptic adds no benefits in postoperative seizure prevention in CSDH patients.
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References
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