Antiepileptic drugs as prophylaxis for postcraniotomy seizures

Vojvodić, Nikola; Ristić, Aleksandar J.; Sokić, Dragoslav

doi:10.1002/14651858.cd007286

Cited by 4 publications

(2 citation statements)

References 10 publications

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“…According to several reports, the PCS induced by pathology or surgical manipulation usually develops within the first or second week after craniotomy. [3–5] There are differences in the onset time between PCS induced by pathology or surgical manipulation and that in our 5 cases.…”

Section: Discussionmentioning

confidence: 66%

“…[ 3 ] In another report, the incidence of seizures after supratentorial surgery related to nontraumatic pathology is estimated as 15 to 20%. [ 4 ] The incidence of seizures in patients who undergo craniotomy is 4.9 to 21.2% for ruptured cerebral aneurysms and 0.1 to 4.4% for unruptured cerebral aneurysms. [ 5 ] However, it is difficult to prove the correlation between the causative pathology and abrupt development of seizures.…”

Section: Discussionmentioning

confidence: 99%

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Prophylactic antibiotics induce early postcraniotomy seizures in neurosurgery patients: A case series

2022

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Rationale: Antibiotics can cause central nervous system disturbances, manifesting as dizziness, confusion, headache, and seizures. Seizures due to antibiotic administration are related to increased excitatory neurotransmission because antibiotics act as competitive antagonists of the γ-aminobutyric acid type A receptor.Patient concerns and clinical findings: All 5 patients, comprising 4 females and one male and aged 45 to 72 years, underwent open craniotomy with additional surgical maneuvers according to their specific disease. All patients presented American Society of Anesthesiologists Physical Status grades 1 to 2. There were no specific underlying diseases, except hepatitis C and hypertension. However, seizures developed sequentially in the 5 patients after neurosurgery.Diagnoses, interventions, and outcomes: Early postcraniotomy seizures (PCS) developed in the patients after neurosurgery. Prophylactic antibiotics were administered in all cases to prevent infection due to open craniotomy. This included the administration of 10 g and 2 g of an antibiotic (cefotiam HCL; Jetiam Intravenous Injection 1g ® ) an hour before the surgery in the ward and half an hour before the surgery in the operating room, respectively. After surgery, cefotiam HCL 2 g was administered in all patients on the day of surgery. Five patients had myoclonic seizure or generalized tonic-clonic seizure several times at emergence or in the intensive care unit.Lessons: Early PCS occurred in every patient when an overdose of the prophylactic antibiotic was administered. This report showed that the preoperative prophylactic antibiotic cefotiam administered in double doses evoked early PCS within a few hours of drug administration. Furthermore, such experiences caution that preoperative intravenous cephalosporins, including cefotiam, should be administered carefully in open craniotomy.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Prophylactic antibiotics induce early postcraniotomy seizures in neurosurgery patients: A case series

2022

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