[Prophylactic antiepileptic treatment of cerebral aggressions]

On the occasion of the First Congress of the Spanish Anti Epilepsy League we had reviewed the use of antiepileptic drugs for preventing postoperative and posttraumatic seizures.

Two specific causes of epilepsy are particularly relevant to neurosurgical practice; postoperative and posttraumatic epilepsy. After reviewing the seizures arising after craniotomy for supratentorial conditions such as vascular malformations (aneurysms and arteriovenous malformations), cerebral tumours and supratentorial abscesses and empyemas, we discuss the different types of posttraumatic epilepsy and the risk factors. The pathogenesis of tumour associated epilepsy and the pathophysiological events initiating posttraumatic epilepsy are described. The use of prophylactic antiepileptic drugs is only justified in cases with several risk factors capable to develop seizures.

As no treatments have yet been shown to be effective in preventing the development of epileptic seizures, additional trials are likely to be necessary.