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Results of a Survey of Neurosurgical Practice Patterns Regarding the Prophylactic use of Anti-Epilepsy Drugs in Patients with Brain Tumors

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Summary

Introduction: The American Association of Neurology issued guidelines discouraging the prophylactic use of anti-epilepsy drugs (AEDs) in patients with brain tumors. We surveyed neurosurgeons to evaluate practice patterns with regard to using AEDs in neurosurgical patients with brain tumors. Methods: The survey consisted of 18 questions. Two group email blasts containing an internet link to the survey were sent to members of the American Association of Neurological Surgeons with email addresses. Uni- and multi-variate analysis of the responses was performed using t-test, Fisher’s exact test, or chi-squared test, where appropriate. Results: The response rate was 15.5% (386/2491). The majority of respondents (270/386; 70.0%) had more than 5 years of experience in neurosurgery. Most respondents described their practices as general (224/379; 59.1%); about one-third were members of the Joint Section on Tumors (136/381; 35.7%). More than 70% of respondents reported routine use of AED prophylaxis for patients with intra-axial gliomas or brain metastases. AED prophylaxis was also routinely used for extra-axial benign tumors or stereotactic biopsies by 53.8% and 21.4%, respectively. On multivariate analysis, the number of years in practice of ABNS certified neurosurgeons was the strongest predictor for the use of AED prophylaxis. Conclusions: Routine use of AED prophylaxis in patients with brain tumors undergoing neurosurgical procedures remains the prevailing practice pattern among members of the AANS. Additional larger prospective studies with appropriate patient stratification culminating in development of neurosurgical guidelines on AED prophylaxis in brain tumor patients is warranted.

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Authors and Affiliations

  1. Department of Neurosurgery, The Cleveland Clinic Brain Tumor Institute, 9500 Euclid Ave, ND-40, Cleveland, OH, 44195, USA

    Vitaly Siomin, Lilyana Angelov & Michael A. Vogelbaum

  2. Department of Biostatistics and Epidemiology, Brain Tumor Institute Cleveland Clinic Foundation, Cleveland, Ohio, USA

    Liang Li

Authors
  1. Vitaly Siomin
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  2. Lilyana Angelov
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  3. Liang Li
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  4. Michael A. Vogelbaum
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Correspondence to Michael A. Vogelbaum.

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Siomin, V., Angelov, L., Li, L. et al. Results of a Survey of Neurosurgical Practice Patterns Regarding the Prophylactic use of Anti-Epilepsy Drugs in Patients with Brain Tumors. J Neurooncol 74, 211–215 (2005). https://doi.org/10.1007/s11060-004-6912-4

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  • DOI: https://doi.org/10.1007/s11060-004-6912-4

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