Epileptic seizures as an early complication of neurosurgery

The appearance of epileptic seizures in the early postoperative period (first 10 days) after neurosurgery is an uncommon complication. A retrospective study of 600 patients operated on for glioma, meningioma, metastatic tumor, hydatid cyst, cerebral hemorrhage and head injury (100 cases each) is the subject of this report. In 6% of the total group, seizures were found during the first 10 days following surgery. They usually appeared during the first 48 hours. In most cases (78%), fits were of the partial motor type, originating in the frontoparietal (central) region. The clinical course was benign in most cases. Good control of seizures was usually obtained by common anticonvulsants and except for a few cases, the prognosis was not worsened by the appearance of these early fits. The pathophysiology of early seizures, which are not related to cerebral scarring, is discussed. It is concluded that they are related to biochemical alterations produced by surgery, similar to what happens in early post traumatic epilepsy or in cases of seizures appearing in the early stages of cerebrovascular accidents.