{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:52:41Z","timestamp":1784559161157,"version":"3.55.0"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T00:00:00Z","timestamp":1664236800000},"content-version":"vor","delay-in-days":3222,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:p>\n          Background: The risk of developing immediate postoperative seizures in patients undergoing supratentorial brain tumor surgery without anti-epileptic drug (AED) prophylaxis is 15-20%. Patients who present with pre-operative seizures and patients with supratentorial meningioma or supratentorial low grade gliomas are at significantly higher risk. There is little data on the efficacy of levetiracetam as a prophylactic AED in the immediate postoperative period (within 7 days of surgery) in these patients. Methods: We conducted a retrospective chart review of 165 adult patients classified as higher risk for postoperative seizures who underwent brain tumor resection at Duke University Hospital between time May 2010 and December 2011. All patients had received levetiracetam monotherapy in doses of 1000-3000 mg\/day in the immediate postoperative period. Results: We identified 165 patients with following tumor locations: Frontal 83 (50.3%), Temporal 37 (22.4%), Parietal 30 (18.2%), Occipital 2 (1.2%) and 13 (7.8%) with single lesions involving more than one lobe. Histology revealed: Glioma 98 (59.4%), Meningioma 57 (34.5%) and Brain Metastases 6 (3.6%). Preoperatively, 88\/165 (53.3%) patients had presented with seizures. 12\/165 patients (7.3%) developed clinical seizures (generalized 10, partial 2) in the immediate post-operative period. Other than somnolence in 7 patients (4.2%), no major side-effects were noted. Conclusions: The incidence of seizures was significantly lower in patients treated with levetiracetam (7.3%) when compared with the expected (15-20%) rate without AED prophylaxis based on the previous literature. Levetiracetam appears effective and safe for seizure prevention in patients undergoing brain tumor resection and who are at significantly higher risk of developing post-operative seizures. These findings warrant confirmation in a prospective randomized trial.<\/jats:p>","DOI":"10.4103\/1793-5482.125658","type":"journal-article","created":{"date-parts":[[2014,1,22]],"date-time":"2014-01-22T09:24:44Z","timestamp":1390382684000},"page":"169-173","source":"Crossref","is-referenced-by-count":41,"title":["Levetiracetam seizure prophylaxis in craniotomy patients at high risk for postoperative seizures"],"prefix":"10.1055","volume":"8","author":[{"given":"Sankalp","family":"Gokhale","sequence":"additional","affiliation":[{"name":"Department of Neurology, Division of Neurocritical Care, Duke University Medical Center, Durham, North Carolina 27710"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shariq","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Division of Neuro Anesthesia, Duke University Medical Center, Durham, North Carolina 27710"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery and Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan","family":"Friedman","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"McDonagh","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Neurology, Division of Neuro Anesthesiology, Duke University Medical Center, Durham, North Carolina 27710"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,9,27]]},"reference":[{"key":"key-10.4103\/1793-5482.125658-1","first-page":"1886","volume-title":"Practice parameter: Anticonvulsant prophylaxis in patients with newly diagnosed brain tumors.Report of the Quality Standards Subcommittee of the American Academy of Neurology","author":"Glantz","year":"2000","journal-title":"Neurology"},{"key":"key-10.4103\/1793-5482.125658-2","first-page":"1519","volume-title":"Efficacy of anti-epileptic drugs in patients with gliomas and seizures","author":"van","year":"2009","journal-title":"J Neurol"},{"key":"key-10.4103\/1793-5482.125658-3","first-page":"589","volume-title":"Factors influencing seizures in adult patients with supratentorial astrocytic tumors","author":"Hwang","year":"2004","journal-title":"Acta Neurochir"},{"key":"key-10.4103\/1793-5482.125658-4","first-page":"479","volume-title":"Epilepsy and gliomas: Incidence and treatment in 119 patients","author":"Pace","year":"1998","journal-title":"J Exp Med Cancer Res: CR"},{"key":"key-10.4103\/1793-5482.125658-5","first-page":"540","volume-title":"Seizure prognosis of patients with low-grade tumors","author":"Kahlenberg","year":"2012","journal-title":"Seizure: Br Epilepsy Association"},{"key":"key-10.4103\/1793-5482.125658-6","unstructured":"Chaichana KL, Pendleton C, Zaidi H, et al. Seizure Control for Patients Undergoing Meningioma Surgery. World neurosurgery 2012."},{"key":"key-10.4103\/1793-5482.125658-7","first-page":"565","volume-title":"Outcomes after discontinuation of antiepileptic drugs after surgery in patients with low grade brain tumors and meningiomas","author":"Das","year":"2012","journal-title":"J Neurooncol"},{"key":"key-10.4103\/1793-5482.125658-8","first-page":"291","volume-title":"Effectiveness of antiepileptic prophylaxis used with supratentorial craniotomies: A meta-analysis","author":"Kuijlen","year":"1996","journal-title":"Seizure: The Br Epilepsy Association"},{"key":"key-10.4103\/1793-5482.125658-9","first-page":"101","volume-title":"Perioperative levetiracetam for prevention of seizures in supratentorial brain tumor surgery","author":"Zachenhofer","year":"2011","journal-title":"J Neurooncol"},{"key":"key-10.4103\/1793-5482.125658-10","first-page":"665","volume-title":"Efficacy and tolerability of levetiracetam versus phenytoin after supratentorial neurosurgery","author":"Milligan","year":"2008","journal-title":"Neurology"},{"key":"key-10.4103\/1793-5482.125658-11","first-page":"253","volume-title":"The incidence of postoperative seizures","author":"Foy","year":"1981","journal-title":"Acta Neurochir"},{"key":"key-10.4103\/1793-5482.125658-12","first-page":"672","volume-title":"Phenytoin and postoperative epilepsy.A double-blind study","author":"North","year":"1983","journal-title":"J Neurosurg"},{"key":"key-10.4103\/1793-5482.125658-13","first-page":"221","volume-title":"Epilepsy after craniotomy and the place of prophylactic anticonvulsant drugs: Discussion paper","author":"Shaw","year":"1991","journal-title":"J R Soc Med"},{"key":"key-10.4103\/1793-5482.125658-14","first-page":"240","volume-title":"Predictors of seizure freedom after resection of supratentorial low-grade gliomas.A review","author":"Englot","year":"2011","journal-title":"J Neurosurg"},{"key":"key-10.4103\/1793-5482.125658-15","first-page":"384","volume-title":"Postoperative epilepsy: A double-blind trial of phenytoin after craniotomy","author":"North","year":"1980","journal-title":"Lancet"},{"key":"key-10.4103\/1793-5482.125658-16","first-page":"717","volume-title":"The course of seizure disorders in patients with malignant gliomas","author":"Moots","year":"1995","journal-title":"Arch Neurol"},{"key":"key-10.4103\/1793-5482.125658-17","first-page":"474","volume-title":"Comparative double blind clinical trial of phenytoin and sodium valproate as anticonvulsant prophylaxis after craniotomy: Efficacy, tolerability, and cognitive effects","author":"Beenen","year":"1999","journal-title":"J Neurol Neurosurg,"},{"key":"key-10.4103\/1793-5482.125658-18","first-page":"705","volume-title":"Postoperative seizures following the resection of convexity meningiomas: Are prophylactic anticonvulsants indicated.Clinical article?","author":"Sughrue","year":"2011","journal-title":"Journal of neurosurgery"},{"key":"key-10.4103\/1793-5482.125658-19","first-page":"483","volume-title":"Prophylactic antiepileptic drug therapy in patients undergoing supratentorial meningioma resection: A systematic analysis of efficacy","author":"Komotar","year":"2011","journal-title":"Journal of neurosurgery"},{"key":"key-10.4103\/1793-5482.125658-20","doi-asserted-by":"crossref","unstructured":"Wu AS, Trinh VT, Suki D, et al. A prospective randomized trial of perioperative seizure prophylaxis in patients with intraparenchymal brain tumors. 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