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01-09-2013 | Original Research Article

Levetiracetam Compared with Valproic Acid for the Prevention of Postoperative Seizures After Supratentorial Tumor Surgery: A Retrospective Chart Review

Authors: Young Jin Lee, Tackeun Kim, So Hyun Bae, Young-Hoon Kim, Jung Ho Han, Chang-Ho Yun, Chae-Yong Kim

Published in: CNS Drugs | Issue 9/2013

Abstract

Introduction

Antiepileptic drugs are commonly given for perioperative prophylaxis after brain tumor surgery, and there has been growing interest in levetiracetam, a second-generation antiepileptic drug. This retrospective study compared the seizure outcomes, side effects and durability of levetiracetam with valproic acid after a craniotomy for supratentorial brain tumors.

Methods

Between 2009 and 2012, 282 consecutive patients with a supratentorial brain tumor underwent a craniotomy at Seoul National University Bundang Hospital. Of these patients, 51 (18.1 %) and 231 (81.9 %) were pre-operatively administered levetiracetam and valproic acid, respectively. The postoperative seizure outcomes (within 1 month after surgery) and the long-term side effects of both drugs were evaluated.

Results

Of the 51 patients in the levetiracetam group, 4 (7.8 %) experienced postoperative seizures after brain tumor surgery, and 15 (6.5 %) of the 231 patients in the valproic acid group experienced postoperative seizures (p = 0.728). The long-term complication rate of the valproic acid group (26.8 %; 62/231) was significantly higher than that of the levetiracetam group (9.8 %; 5/51) [p = 0.010]. In the valproic acid group, 10 hepatotoxicities, 20 hyperammonemias and 10 hematologic abnormalities (6 thrombocytopenias, 3 pancytopenias, and 1 leucopenia) occurred. Moreover, 89 patients (38.5 %) in the valproic acid group changed or added other anticonvulsants because of side effects or uncontrolled seizures, whereas only 9 patients (17.6 %) in the levetiracetam group changed or added other anticonvulsants (p = 0.005).

Conclusions

The postoperative seizure control rates of levetiracetam and valproic acid were not statistically significantly different; however, levetiracetam may be superior to valproic acid in terms of its safety and durability after supratentorial tumor surgery.

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Title: Levetiracetam Compared with Valproic Acid for the Prevention of Postoperative Seizures After Supratentorial Tumor Surgery: A Retrospective Chart Review
Authors: Young Jin Lee
Tackeun Kim
So Hyun Bae
Young-Hoon Kim
Jung Ho Han
Chang-Ho Yun
Chae-Yong Kim
Publication date: 01-09-2013
Publisher: Springer International Publishing
Published in: CNS Drugs / Issue 9/2013
Print ISSN: 1172-7047
Electronic ISSN: 1179-1934
DOI: https://doi.org/10.1007/s40263-013-0094-6

At a glance: The STEP trials

Springer Medicine

Levetiracetam Compared with Valproic Acid for the Prevention of Postoperative Seizures After Supratentorial Tumor Surgery: A Retrospective Chart Review

Abstract

Introduction

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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