A Review of 669 Neurosurgical Cases

Anti-Epileptic Drugs in Geriatric Neurosurgery: A Review of 669 Neurosurgical Cases
Omar Al-Taei1, Abdulrahman Al-Mirza1, Humaid Al Kalbani2, Mohammed Ali3, and Tariq Al-Saadi3,4
1College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
2Department of Ophthalmology, Oman Medical Specialty Board, Muscat, Sultanate of Oman
3Department of Neurosurgery, Khoula Hospital, Muscat, Sultanate of Oman
4Department of Neurology & Neurosurgery-Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Canada
Corresponding Author:
Tariq Al-Saadi ,Tel: +514-398-6644, Fax: +514-398-5358, Email: t.dhiyab@hotmail.com
Received: August 14, 2021; Revised: December 19, 2021   Accepted: February 9, 2022.  Published online: June 30, 2022.
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ABSTRACT
Background and Purpose: Patients over the age of 75 are more likely to develop epilepsy than children under the age of 10. Patients of all ages are prescribed anti-epileptic drugs; however, those over the age of 65 are the most typically prescribed group.

Methods: This is a retrospective study of geriatric cases admitted to the Neurosurgery Department in Khoula Hospital from January 1, 2016 to December 31, 2019. A medical records of 669 patients were identified. Patients’ demographics, risk factors, usage of anti-epileptic drug (AED), type of tumor, tumor location, neuro-vital signs diagnosis, Glasgow coma scale on arrival, treatment types, and length of stay (LOS) were recorded.

Results: The prevalence of AEDs use was 19%. Patients with traumatic brain injury (TBI) were found to have a higher rate of using AEDs (32.1%) followed by patients with oncological and vascular pathologies, respectively (30.1% and 21.6%). There was a significant relationship between the utilization of AEDs among different neurological diseases investigated (pp=0.001). There was a significant difference in the LOS and the usage of AEDs. Added to that, the results signify a relationship between the intensive care unit (ICU) admission and the utilization of AEDs in which the majority of the patients who were not on AEDs were not admitted to the ICU (pConclusions: AEDs are used as prophylaxis to prevent seizures before most neurosurgical procedures and were commonly prescribed in TBI patients. Phenytoin was found to be the commonest AEDs utilized among the different neurosurgical categories followed by levetiracetam.
Key words:
Antiepileptic | Phenytoin | Traumatic brain injury | Brain tumor | Geriatric | Neurosurgery



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