Antiepileptic Drug Prophylaxis in Unruptured Intracranial Aneurysms

Abstract

Aim:Postoperative seizure disorder can affect the outcome of patients with unruptured intracranial aneurysms. The objective of this study is to evaluate the frequency of postoperative seizures and the need for antiepileptic prophylaxis after the surgery of unruptured intracranial aneurysms. Methods:The medical data of 30 patients who were operated for unruptured intracranial aneurysms were reviewed for age and sex of the patients, location of the aneurysms, length of hospital stay, postoperative complications, and history of preoperative seizures. Postoperative early and late seizures were investigated through their relation with antiepileptic drug usage. Results:Postoperative seizures were observed in 2 patients (7.14%): 1 early seizure in the first week and 1 late seizure occurred 2 years after the surgery. All seizures were generalized tonic clonic in type. The patient with early seizure had left internal capsule ischemia. The patient with late seizure had encephalomalacia in the operative field on magnetic resonance imaging. Conclusions:Antiepileptic prophylaxis in unruptured intracranial aneurysms should be ceased if the patient has no history of preoperative epilepsy and if no seizure is observed at the end of 3 months.