{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T22:31:27Z","timestamp":1781476287885,"version":"3.54.1"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T00:00:00Z","timestamp":1704931200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>Early postoperative seizures (EPS) are a common complication of brain tumor surgery. EPS can lead to hemorrhage, cerebral hypoxia, increased intracranial pressure, longer hospitalization, reduced quality of life, decreased overall survival, and increased morbidity. However, there are no formal guidelines on perioperative antiseizure medication (ASM) management in patients with tumor-related epilepsy who are deemed high risk for EPS. In this study, we describe the case of a 38-year-old man with isocitrate dehydrogenase-mutant mixed glioma and two episodes of EPS manifesting with status epilepticus during prior tumor surgeries and who presented with tumor progression. The Tumor Board recommended awake craniotomy with direct electrical stimulation (DES). The patient was administered aggressive preoperative \u201cprophylactic\u201d ASMs by increasing the maintenance doses of lacosamide and levetiracetam by 25% 48\u2005h before surgery. An intravenous load of fosphenytoin (20\u2005mg\/kg) was administered in the operating room before DES, followed by a maintenance dosing of 300\u2005mg\/day for 14 days. EPS did not occur, and he was discharged home on postoperative day 4. Our case illustrates that aggressive perioperative prophylactic ASM therapy beyond the maintenance ASM regimen can be considered in patients with tumor-related epilepsy at risk of EPS.<\/jats:p>","DOI":"10.3389\/fsurg.2023.1282013","type":"journal-article","created":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T04:55:46Z","timestamp":1704948946000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Case Report: \u201cAggressive\u201d perioperative antiseizure medication prophylaxis in patients with glioma-related epilepsy at high risk of early postoperative seizures following awake craniotomy"],"prefix":"10.3389","volume":"10","author":[{"given":"Brin E.","family":"Freund","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt","family":"Jaeckle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Quinones-Hinojosa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anteneh M.","family":"Feyissa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,1,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1111\/j.1528-1167.2009.02285.x","article-title":"Recommendation for a definition of acute symptomatic seizure","volume":"51","author":"Beghi","year":"2010","journal-title":"Epilepsia"},{"key":"B2","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1227\/01.neu.0000429847.91707.97","article-title":"Intraoperative seizures during awake craniotomy: incidence and consequences: analysis of 477 patients","volume":"73","author":"Nossek","year":"2013","journal-title":"Neurosurgery"},{"key":"B3","first-page":"379","article-title":"Risk of perioperative seizures in patients undergoing craniotomy with intraoperative brain mapping","volume":"81","author":"Conte","year":"2015","journal-title":"Minerva Anestesiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1227\/NEU.0000000000000644","article-title":"Initial experience using awake surgery for glioma: oncological, functional, and employment outcomes in a consecutive series of 25 cases","volume":"76","author":"Mandonnet","year":"2015","journal-title":"Neurosurgery"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1661","DOI":"10.3171\/2017.1.JNS162913","article-title":"Comparative analysis of monotherapy versus duotherapy antiseizure drug management for postoperative seizure control in patients undergoing an awake craniotomy","volume":"128","author":"Eseonu","year":"2018","journal-title":"J Neurosurg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"S1878-8750(23)01525-5","DOI":"10.1016\/j.wneu.2023.10.119","article-title":"Early postoperative seizures following awake craniotomy and functional brain mapping for lesionectomy","author":"Freund","year":"2023","journal-title":"World Neurosurg"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2019.105529","article-title":"Efficacy of perioperative anticonvulsant prophylaxis in seizure-na\u00efve glioma patients: a meta-analysis","volume":"186","author":"Wang","year":"2019","journal-title":"Clin Neurol Neurosurg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-020-70754-z","article-title":"Early postoperative seizures (EPS) in patients undergoing brain tumour surgery","volume":"10","author":"Ersoy","year":"2020","journal-title":"Sci Rep"},{"key":"B9","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1007\/s10143-016-0771-2","article-title":"Brain tumors in eloquent areas: a European multicenter survey of intraoperative mapping techniques, intraoperative seizures occurrence, and antiepileptic drug prophylaxis","volume":"40","author":"Spena","year":"2017","journal-title":"Neurosurg Rev"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3171\/2017.8.FOCUS17442","article-title":"A systematic review of perioperative seizure prophylaxis during brain tumor resection: the case for a multicenter randomized clinical trial","volume":"43","author":"Chandra","year":"2017","journal-title":"Neurosurg Focus"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1274","DOI":"10.3171\/2017.10.JNS172236","article-title":"Effectiveness of perioperative antiepileptic drug prophylaxis for early and late seizures following oncologic neurosurgery: a meta-analysis","volume":"130","author":"Joiner","year":"2019","journal-title":"J Neurosurg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1007\/s10143-019-01085-5","article-title":"Risk factors and control of seizures in 778 Chinese patients undergoing initial resection of supratentorial meningiomas","volume":"43","author":"Li","year":"2020","journal-title":"Neurosurg Rev"},{"key":"B13","doi-asserted-by":"publisher","first-page":"483","DOI":"10.3171\/2011.4.JNS101585","article-title":"Prophylactic antiepileptic drug therapy in patients undergoing supratentorial meningioma resection: a systematic analysis of efficacy\u2014a review","volume":"115","author":"Komotar","year":"2011","journal-title":"J Neurosurg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"E147","DOI":"10.1093\/ons\/opab110","article-title":"Intraoperative seizure detection during active resection of glioblastoma through a novel hollow circular electrocorticography array","volume":"21","author":"Domingo","year":"2021","journal-title":"Oper Neurosurg"},{"key":"B15","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1007\/s11060-023-04495-0","article-title":"Enhanced sensitivity of electrocorticography during awake craniotomy using a novel circular grid electrode","volume":"165","author":"Freund","year":"2023","journal-title":"J Neurooncol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1007\/s11060-019-03131-0","article-title":"Awake craniotomies for epileptic gliomas: intraoperative and postoperative seizure control and prognostic factors","volume":"142","author":"Wang","year":"2019","journal-title":"J Neurooncol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fonc.2022.905976","article-title":"Meningioma related epilepsy\u2014pathophysiology, pre\/postoperative seizures predicators and treatment","volume":"12","author":"Elbadry Ahmed","year":"2022","journal-title":"Front Oncol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1093\/neuros\/nyx023","article-title":"Awake craniotomy vs craniotomy under general anesthesia for perirolandic gliomas: evaluating perioperative complications and extent of resection","volume":"81","author":"Eseonu","year":"2017","journal-title":"Neurosurgery"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1058","DOI":"10.1016\/j.clinph.2019.03.006","article-title":"Factors that modify the risk of intraoperative seizures triggered by electrical stimulation during supratentorial functional mapping","volume":"130","author":"Dineen","year":"2019","journal-title":"Clin Neurophysiol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1212\/01.wnl.0000349664.64710.86","article-title":"Efficacy and tolerability of levetiracetam versus phenytoin after supratentorial neurosurgery","volume":"73","author":"Sethi","year":"2009","journal-title":"Neurology"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1180","DOI":"10.1016\/j.jocn.2011.02.018","article-title":"The effect of antiepileptic drugs on coagulation and bleeding in the perioperative period of epilepsy surgery: the Cleveland clinic experience","volume":"18","author":"Manohar","year":"2011","journal-title":"J Clin Neurosci"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.7759\/cureus.24894","article-title":"Levetiracetam versus levetiracetam plus sodium channel blockers for postoperative epileptic seizure prevention in brain tumor patients","volume":"14","author":"Watanabe","year":"2022","journal-title":"Cureus"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2023.1282013\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T04:55:48Z","timestamp":1704948948000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2023.1282013\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,11]]},"references-count":22,"alternative-id":["10.3389\/fsurg.2023.1282013"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2023.1282013","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,11]]},"article-number":"1282013"}}