Dauch W A, Schütze M, Güttinger M, Bauer B L
Neurochirurgische Klinik, Philipps-Universität Marburg.
Zentralbl Neurochir. 1996;57(4):190-5.
Starting in November, 1993, until January, 1994, we performed a survey among 127 Neurosurgical Departments in Austria, Germany, and Switzerland concerning the practice of antiepileptic prophylaxis in head injured patients. Seventy seven percent of the 12-item multiple choice questionnaires were completed and returned. They indicate a variety of attitudes towards prophylaxis for seizures: in 12% of the responding institutions, antiepileptic prophylaxis is given to every brain trauma patient, in 36%, no prophylaxis is carried out. and in 52% some patients receive prophylaxis while others do not. Penetrating injuries, intracranial haemorrhages and electroencephalographic abnormalities were the most frequent reasons why prophylaxis was initiated. Phenytoin is by far the most popular drug, given usually for at least three months, and in most cases monitored by routine serum level observations. Nevertheless, about three out of four neurosurgeons conceded that a general renunciation of antiepileptic prophylaxis after brain trauma might be justified. There is no uniform way in which patients are informed about a possible risk of seizures, as it may be relevant, for instance, in respect of driving abilities.
从1993年11月至1994年1月，我们对奥地利、德国和瑞士的127个神经外科科室就颅脑损伤患者的抗癫痫预防措施开展了一项调查。12项选择题问卷的回复率为77%。这些回复表明了对癫痫预防措施的各种态度：在12%的回复机构中，对每位脑外伤患者都进行抗癫痫预防；36%的机构不进行预防；52%的机构部分患者接受预防，部分患者不接受。穿透性损伤、颅内出血和脑电图异常是开始进行预防的最常见原因。苯妥英是目前最常用的药物，通常使用至少三个月，且大多数情况下通过常规血清水平监测。然而，约四分之三的神经外科医生承认，脑外伤后普遍放弃抗癫痫预防可能是合理的。对于癫痫发作的潜在风险，没有统一的告知患者的方式，因为这可能与例如驾驶能力等方面相关。
