Reasons for continuing medication after epilepsy surgery

  Do you know how long antiepileptic drugs should be continued after epilepsy surgery?  After epilepsy surgery, antiepileptic drugs are required for a certain period of time to maintain and consolidate treatment. Even if the surgery is very successful, antiepileptic drugs are still required. Epilepsy surgery is a period of time in the long-term treatment of epilepsy.  1. Early treatment after surgery Due to the stimulation of the cerebral cortex by surgery and the fluctuation of the concentration of antiepileptic drugs in the blood caused by surgery, seizures and even continuous status epilepticus may occur. Therefore, all antiepileptic drugs should be given Time: Early within one week after surgery, and medication should be given immediately after surgery.  Drug selection: There are no specific criteria for drug selection after surgery, based on preoperative medication, or based on the type of seizure medication that may occur after surgery. In general, the vast majority of patients undergoing surgery have partial epilepsy, and the drugs available are oxcarbazepine, lamotrigine, levetiracetam, deltamethrin, and depakene. The medications can also be adjusted according to the patient’s individual economic situation. In the perioperative period, drugs with fewer side effects, such as oxcarbazepine and levetiracetam, are generally chosen. They can also be applied in combination.  2. Long-term treatment after surgery Purpose: To control possible residual epileptogenic zones, to prevent and control the development of new epileptogenic zones in the cortex with seizure potential, and to prevent and control the formation of epileptogenic zones from surgical scars.  Drug selection: Adjustment with reference to preoperative medication, preferably discontinuing drugs with greater side effects and less effective drugs. If the patient’s prognosis is good, the type of medication applied preoperatively can be reduced. Patients who are left with only aura seizures may be considered for medication reduction according to the frequency, duration and impact of the seizures with reference to the EEG.