Bidziński J, Marchel A, Sherif A
Department of Neurosurgery, Medical Academy, Warsaw, Poland.
Acta Neurochir (Wien). 1992;119(1-4):49-52. doi: 10.1007/BF01541781.
This prospective study was undertaken to evaluate the risk of epilepsy after aneurysm operations. The patients were discharged after operation without any anticonvulsant prophylactic treatment and followed-up for 12 months. Out of 128 such patients 121 were submitted for final evaluation. Epilepsy was diagnosed if two or more seizure attacks occurred during that time. Such attacks occurred in 8 patients, so the risk of epilepsy was estimated at 7% for the 12 months after operation in patients without prophylactic treatment. In another 3 patients single seizures occurred during the follow-up, they were not treated with anticonvulsant drugs; seizures did not recur for up to two years. Detailed analysis of the patients with late epilepsy revealed that most of them were pre-operatively in the 3rd clinical group according to WFNS scale. The rationale for the use of prophylactic anticonvulsants after aneurysm surgery seems to be doubtful in view of this study and data from the literature.
本前瞻性研究旨在评估动脉瘤手术后癫痫发作的风险。患者术后未接受任何抗惊厥预防性治疗即出院，并进行了12个月的随访。在128例此类患者中，121例接受了最终评估。如果在此期间发生两次或更多次癫痫发作，则诊断为癫痫。8例患者出现了此类发作，因此未接受预防性治疗的患者术后12个月癫痫发作风险估计为7%。另外3例患者在随访期间出现单次癫痫发作，未接受抗惊厥药物治疗；癫痫发作长达两年未复发。对晚期癫痫患者的详细分析显示，根据WFNS量表，他们中的大多数术前属于第3临床组。鉴于本研究及文献数据，动脉瘤手术后使用预防性抗惊厥药物的理由似乎值得怀疑。
