Many patients in neurosurgery are discharged from the hospital only at the end of their hospitalization, but they still need a period of recovery after going home. For patients after surgery for supratentorial tumors (meningioma, glioma, craniopharyngioma, etc.), after discharge from the hospital, the doctor in charge will prescribe antiepileptic drugs according to the condition and let the patient continue to take them orally for a period of time after going home. Whether the medication is taken correctly at this stage may also affect the recovery of the condition, so mastering the precautions for taking antiepileptic drugs can help the patient return to normal life and work faster. Duration of medication.
The opinions of neurosurgery experts on the duration of taking antiepileptic drugs are not entirely consistent, for example, the 2009 Clinical Guidelines for Neurosurgery organized by the Chinese Medical Association of the Ministry of Health recommends that for craniotomy for supratentorial tumors, if there are no seizures before and after surgery, prophylactic application of antiepileptic drugs is required for at least 3 months (3-6 months) after surgery; if there are no seizures before surgery and In 2012, the Expert Consensus on the Application of Antiepileptic Drugs after Surgery for Craniosynostosis of the Chinese Antiepileptic Association recommended that antiepileptic drugs should be started after the cessation of anesthetic drugs to prevent immediate seizures. Since there is no evidence that antiepileptic drugs can reduce late seizures (seizures occurring >2 weeks after surgery), prophylactic application of antiepileptic drugs should usually be gradually discontinued 2 weeks after surgery; if the patient has seizures before surgery or has early (within 2 weeks) seizures after surgery, the physician should follow the guidelines of antiepileptic drug use according to the patient’s own situation and treatment. If the patient had seizures before surgery or had early (within 2 weeks) seizures after surgery, the antiepileptic drugs should be selected or adjusted by the doctor according to the patient’s condition and treatment, or the dose should be increased based on the principles of antiepileptic drug use. Seizures are a common symptom of craniosynostosis, and their seizures vary from person to person. Therefore, during the consultation, the doctor in charge often knows the most about the patient’s condition, surgery, and medication. Patients should strictly follow the doctor’s instructions and should not increase, decrease or stop the medication at will to avoid danger. Some medications need to be taken on an empty stomach and some need to be taken after meals, so read the instructions and record in detail what the nurse tells you about the medication so that it can be used safely. Side effects: The most common side effects of antiepileptic drugs are allergies, changes in blood and liver function, and regular review of blood and liver function (about once a month). Dose-related adverse reactions: It refers to the adverse reactions caused by excessive drug dose, rapid dosing or the early stage of taking the drug, such as headache, dizziness, unstable walking, anorexia, nausea, vomiting, fatigue, drowsiness, etc. Generally, the degree is not serious and can be improved or disappeared soon after adjusting the drug dose. Adverse reactions of idiosyncrasy: It refers to the adverse reactions caused by the individual’s over-sensitivity to a certain component of the drug, such as rash, peripheral neuropathy, etc. In this case, you should consult a doctor and make treatment under the guidance of a doctor. Some experts have also found through clinical trials that long-term use of certain antiepileptic drugs may have a certain degree of effect on a person’s attention, reaction speed, fine motor, etc. The principle of drug discontinuation: Some studies have shown that about 60%-70% of patients with epilepsy after tumor surgery can be seizure-free again after antiepileptic drug treatment. The risk of relapse will be carefully evaluated by the physician, and the patient should consider tapering off the antiepileptic medication only after the physician’s evaluation and guidance.
Patients should consider starting to taper off their antiepileptic medications only after evaluation and guidance from their physician.