Prophylactic Topiramate Therapy in Postoperative Seizure

Yang, Seung-Ho; Lee, Kwan-Sung; Hong, Yong-Kil; Park, Chun-Kun; Kim, Moon-Chan; Jeun, Sin-Soo

Original article

Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2006;2(2):143-146.
Published online September 30, 2006.

Prophylactic Topiramate Therapy in Postoperative Seizure

Seung-Ho Yang, Kwan-Sung Lee, Yong-Kil Hong, Chun-Kun Park, Moon-Chan Kim, Sin-Soo Jeun

Department of Neurosurgery, The Catholic University of Korea, Seoul, Korea

Abstract

Objective
The purpose of this study is to evaluate the efficacy of prophylactic topiramate (TPM) therapy on postoperative seizures.
Methods
Seventy nine patients, who underwent supratentorial craniotomy at Kangnam St. Mary’s hospital from 2003 to 2004, were enrolled in this study. Patients underwent surgery for the following：10 meningiomas, 16 aneurysms, 6 gliomas, 16 hypertensive intracranial hematomas, 2 metastatic brain tumors and 29 head traumas. There were 31 female and 48 male patients whose age was between 18 and 80 years (mean age 50.7). TPM therapy (25mg twice a day) was continued for up to six months；thereafter the patients were followed for at least 24 months after surgery.
Results
Seizure developed in five out of 79 patients (6.3%). They included three patients with head trauma and two with low grade glioma. Time interval from the start day of TPM administration to the day of first seizure was 1, 2, 4, 5 and 15 months, respectively. Only one patient developed seizures during the follow-up period without the medication. Adverse events were reported in 10% of patients, but were not a reason for drop-out. Paraesthesia was the most common adverse event.
Conclusion
This data suggests that prophylactic TPM therapy is safe and acceptable for the prevention of postoperative seizures.

Key Words: Anti-epileptic drugs, Prophylactic, Topiramate.