神经外科实践中的抗癫痫药物

IF 0.7 Q4 CLINICAL NEUROLOGY Egyptian journal of neurosurgery Pub Date : 2024-09-03 DOI:10.1186/s41984-024-00318-0
Mohamed Fatah Allah Alsawy
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引用次数: 0

摘要

癫痫是最早被发现的医学疾病之一。古往今来,人们一直在使用各种奇怪的治疗方法。尽管药膏、药物、魔术、灌肠、驱魔、灵修、手术和物理以及行为疗法广受欢迎,但仍未找到治愈的方法。尽管神经外科医生会开具抗癫痫药物(AEDs)治疗癫痫发作,尤其是在围手术期,但目前关于神经外科患者癫痫发作和癫痫管理的文献明显不足。神经外科医生的癫痫治疗范围通常包括脑外伤、肿瘤、蛛网膜下腔出血、脑脓肿和感染患者。根据发作开始的时间,开颅手术后癫痫发作可分为三类:及时(24 小时前)、早期(1 周前)和晚期(1 周后)。三分之一的癫痫发作可能发生在开颅手术后的头一个月内,通常是头三天内,尽管癫痫发作的风险会持续到术后几个月。目前有多代 AEDs,需要进一步研究才能为每一个癫痫发作病例(尤其是神经外科患者等高危人群)确定明确的建议。
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Antiepileptic medications in neurosurgical practice
One of the earliest medical disorders to be identified is epilepsy. Strange and diverse forms of therapy have been used throughout history. A cure has not been found despite the popularity of ointments, medications, magic, enemas, exorcism, spiritualism, surgical and physical, as well as behavioural therapies. There is a notable deficiency of current literature about the management of seizures and epilepsy in neurosurgical patients, despite the fact that neurosurgeons are enrolled in the prescription of antiepileptic drugs (AEDs) for the seizures especially in perioperative periods. Neurosurgeons scope of management of epilepsy usually involve patients with either traumatic brain injury, neoplasms, subarachnoid haemorrhages, and brain abscess and infection. Depending on when they began, post-craniotomy seizures are categorised into three categories: promptly (before 24 h), early (before 1 week), and late (after 1 week). One-third of seizures can occur within the first month after a craniotomy, usually within the first 3 days, even though the risk of seizures persists for several post-operative months. There are multiple generations of AEDs, and further research is required to settle a clear recommendation for each and every case of seizures especially for hard population like the neurosurgical patients.
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