Revista de cirugía y práctica clínica

Life after seizures and neurosurgery

Joey Gaines

A febrile seizure began the 30 year journey from captivity of seizures to freedom after neurosurgery: Left Anterior Temporal Lobectomy/ Left Hippocampus removal had to be considered for best end result. 80% of patients after surgery were seizure free one year post op and 90% showed marked improvement.(neuro.mcg.eduepisurg.htm) It was suspected that he had been having petite mal seizures all along. At age 14 and 16 years of age, he experienced seizure activity that put him into a coma for 3 days leaving him with some memory loss. By the time the subject was 32, medication was no longer effective, having approximately 800 seizures a year. It was determined at this time that surgery was his only option if he was to continue to live. Because of the extent of the surgery, it was thought it would leave him a nonfunctioning adult that he would be bound to a wheelchair and unable to care for himself, when he opened his eyes after surgery he had no memory. No memory of the ability to function in everyday living, or who or what people surrounding him in hospital were. He had no memory of family or friends, that he had children or a wife and had difficulty retaining short term memory without continual repetition. But he learned again how to eat, walk, use the toilet and care for his personal needs. He returned to work, drives and lives on his own. The one thing he did retain was his craft as a master welder. To determine the incidence, risk factors and outcomes of early post-craniotomy seizures. This was a retrospective cohort study of all patients who underwent craniotomy for primary brain tumor resection (2002-2011) and admitted postoperatively to the intensive care unit. The patients were divided into 2 groups depending on the occurrence of seizures within 7 days. One-hundred-ninety-three patients were studied: 35.8% had preoperative seizure history and 16.6% were on prophylactic antiepileptic drugs (AEDs). Twenty-seven (14%) patients had post-craniotomy seizures. The tumors were mostly meningiomas (63% for the postcraniotomy seizures group versus 58.1% for the other group; p=0.63) and supratentorial (92.6% for the post-craniotomy seizures versus 78.4% for the other group.