Time to dispense with antiepileptic drug prophylaxis in brain tumor surgery?

2021 ◽  
Author(s):  
Johan Pallud ◽  
Gilles Huberfeld
2019 ◽  
Vol 130 (4) ◽  
pp. 1274-1282 ◽  
Author(s):  
Evan F. Joiner ◽  
Brett E. Youngerman ◽  
Taylor S. Hudson ◽  
Jingyan Yang ◽  
Mary R. Welch ◽  
...  

OBJECTIVEThe purpose of this meta-analysis was to evaluate the impact of perioperative antiepileptic drug (AED) prophylaxis on short- and long-term seizure incidence among patients undergoing brain tumor surgery. It is the first meta-analysis to focus exclusively on perioperative AED prophylaxis among patients undergoing brain tumor surgery.METHODSThe authors searched PubMed/MEDLINE, Embase, Cochrane Central Register of Controlled Trials, clinicaltrials.gov, and the System for Information on Gray Literature in Europe for records related to perioperative AED prophylaxis for patients with brain tumors. Risk of bias in the included studies was assessed using the Cochrane risk of bias tool. Incidence rates for early seizures (within the first postoperative week) and total seizures were estimated based on data from randomized controlled trials. A Mantel-Haenszel random-effects model was used to analyze pooled relative risk (RR) of early seizures (within the first postoperative week) and total seizures associated with perioperative AED prophylaxis versus control.RESULTSFour RCTs involving 352 patients met the criteria of inclusion. The results demonstrated that perioperative AED prophylaxis for patients undergoing brain tumor surgery provides a statistically significant reduction in risk of early postoperative seizures compared with control (RR = 0.352, 95% confidence interval 0.130–0.949, p = 0.039). AED prophylaxis had no statistically significant effect on the total (combined short- and long-term) incidence of seizures.CONCLUSIONSThis meta-analysis demonstrates for the first time that perioperative AED prophylaxis for brain tumor surgery provides a statistically significant reduction in early postoperative seizure risk.


2018 ◽  
Author(s):  
C.H.B. van Niftrik ◽  
F. van der Wouden ◽  
V. Staartjes ◽  
J. Fierstra ◽  
M. Stienen ◽  
...  

2019 ◽  
Author(s):  
Estela Val Jordan ◽  
Agustín Nebra Puertas ◽  
Juan Casado Pellejero ◽  
Maria Dolores Vicente Gordo ◽  
Concepción Revilla López ◽  
...  

Author(s):  
Gennadiy A. Katsevman ◽  
Walter Greenleaf ◽  
Ricardo García-García ◽  
Maria Victoria Perea ◽  
Valentina Ladera ◽  
...  

2020 ◽  
Vol 2 (Supplement_3) ◽  
pp. ii2-ii2
Author(s):  
Tatsuya Abe

Abstract It is reported that the development of new perioperative motor deficits was associated with decreased overall survival despite similar extent of resection and adjuvant therapy. The maximum safe resection without any neurological deficits is required to improve overall survival in patients with brain tumor. Surgery is performed with various modalities, such as neuro-monitoring, photodynamic diagnosis, neuro-navigation, awake craniotomy, intraoperative MRI, and so on. Above all, awake craniotomy technique is now the standard procedure to achieve the maximum safe resection in patients with brain tumor. It is well known that before any treatment, gliomas generate globally (and not only focally) altered functional connectomics profiles, with various patterns of neural reorganization allowing different levels of cognitive compensation. Therefore, perioperative cortical mapping and elucidation of functional network, neuroplasticity and reorganization are important for brain tumor surgery. On the other hand, recent studies have proposed several gene signatures as biomarkers for different grades of gliomas from various perspectives. Then, we aimed to identify these biomarkers in pre-operative and/or intra-operative periods, using liquid biopsy, immunostaining and various PCR methods including rapid genotyping assay. In this presentation, we would like to demonstrate our surgical strategy based on molecular and functional connectomics profiles.


2021 ◽  
Vol 201 ◽  
pp. 106420
Author(s):  
Mayla Santana Correia ◽  
Iuri Santana Neville ◽  
Cesar Cimonari de Almeida ◽  
Cintya Yukie Hayashi ◽  
Luana Talita Diniz Ferreira ◽  
...  

2010 ◽  
Vol 101 (1) ◽  
pp. 101-106 ◽  
Author(s):  
Iris Zachenhofer ◽  
Markus Donat ◽  
Stefan Oberndorfer ◽  
Karl Roessler

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