The need for valproic acid as prophylaxis in neurosurgery patients

Using anti-epileptic drugs in neurosurgery patients is a routine practice. This controlled trial aimed to assess whether prophylaxis with Valproate in brain surgery patients is justified or not. Group A (n=50; controls) patients received valproic acid postoperatively for three months, while group B (n=50; subjects) received a placebo. Serum valproic acid levels between 50-125g/ml were required. Kendall's Tau was applied to see the correlation between the 'frequency of seizures' between different surgical procedures performed and the extent of manipulations-EOMs. A wireless EMOTIV EPOC device was used to visualize the Electroencephalogram patterns. In controls, 12 patients had one seizure and only two patients had 2 seizures. In the placebo group, 13 patients had one and 4 patients had 2 seizures. The seizure frequency was highest amongst brain tumor patients. An insignificant difference was found between the seizure frequencies of the placebo and control groups. A statistically insignificant correlation was found between seizure frequency and independent variables: surgical procedures and EOM (%). Using an AED or not, the frequency of seizures did not substantially reduce over the postoperative period. If not necessary, the anti-epileptic medication that is frequently provided as a prophylactic against seizures in the post-operative period should not be administered.