Chinese guideline on the application of anti-seizure medications in the perioperative period of supratentorial craniocerebral surgery

Shuli Liang¹, Xing Fan², Feng Chen³, Yonghong Liu³, Binghui Qiu⁴, Kai Zhang⁵, Songtao Qi⁴, Guojun Zhang³, Jinfang Liu⁶, Jianguo Zhang², Jun Wang⁴, Xiu Wang⁵, Ziyang Song³, Guoming Luan⁷, Xuejun Yang⁸, Rongcai Jiang⁹, Hua Zhang¹⁰, Lei Wang⁵, Yongping You¹¹, Kai Shu¹², Xiaojie Lu¹³, Guoyi Gao¹⁴, Bo Zhang¹⁵, Jian Zhou⁷, Hai Jin¹⁶, Kaiwei Han¹⁷, Yiming Li¹⁷, Junji Wei¹⁸, Kun Yang¹⁹, Gan You⁵, Hongming Ji²⁰, Yuwu Jiang²¹, Yi Wang²², Zhiguo Lin²³, Yan Li²⁴, Xuewu Liu²⁵, Jie Hu²⁶, Junming Zhu²⁷, Wenling Li²⁸, Yongxin Wang²⁹, Dezhi Kang³⁰, Hua Feng³¹, Tinghong Liu³, Xin Chen⁹, Yawen Pan³², Zhixiong Liu⁶, Gang Li³³, Yunqian Li³⁴, Ming Ge³⁵, Xianming Fu³⁶, Yuping Wang³⁷, Dong Zhou³⁸, Shichuo Li³⁹, Tao Jiang⁴⁰, Lijun Hou⁴¹, Zhen Hong⁴²

Affiliations

¹ Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No. 56 Nanlishi Road, Xicheng District, Beijing 100045, China.
² Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
³ Xijing Hospital of Airforce Medical University, Xi'an, China.
⁴ Nanfang Hospital, Southern Medical University, Guangzhou, China.
⁵ Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
⁶ Xiangya Hospital, Central South University, Changsha, China.
⁷ Sanbo Brain Hospital, Capital Medical University, Beijing, China.
⁸ Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China.
⁹ Tianjin Medical University General Hospital, Tianjin, China.
¹⁰ Department of Neurosurgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.
¹¹ Jiangsu Provincial People's Hospital, Nanjing, China.
¹² Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
¹³ The Affiliated Hospital, Jiangnan University, Wuxi, China.
¹⁴ Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
¹⁵ Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China.
¹⁶ General Hospital of Northern Theater Command, Shenyang, China.
¹⁷ Shanghai Changzheng Hospital, Shanghai Neurosurgical Institute, Shanghai, China.
¹⁸ Peking Union Medical College Hospital, Beijing, China.
¹⁹ The First Affiliated Hospital, Hainan Medical University, Haikou, China.
²⁰ Shanxi Provincial People's Hospital, Taiyuan, China.
²¹ Peking University First Hospital, Beijing, China.
²² Children's Hospital of Fudan University, Shanghai, China.
²³ First Affiliated Hospital, Harbin Medical University, Harbin, China.
²⁴ Children's Hospital of Soochow University, Suzhou, China.
²⁵ Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China; Institute of Epilepsy, Shandong University, Jinan, China.
²⁶ Huashan Hospital, Fudan University, Shanghai, China.
²⁷ The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China.
²⁸ The Second Hospital of Hebei Medical University, Shijiazhuang, China.
²⁹ The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
³⁰ The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
³¹ The Southwest Hospital, Army Medical University, Chongqing, China.
³² Lanzhou University Second Hospital, Lanzhou, China.
³³ Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
³⁴ The First Hospital of Jilin University, Changchun, China.
³⁵ Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China; Key Laboratory of Major Disease in Children, Ministry of Education, Beijing, China.
³⁶ The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei, China.
³⁷ Xuanwu Hospital, Capital Medical University, Beijing, China.
³⁸ West China Hospital, Sichuan University, Chengdu, China.
³⁹ China Association Against Epilepsy, No. 135 Xizhimen Wai Avenue, Beijing 100044, China.
⁴⁰ Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring West Road, Fengtai District, Beijing 10070, China.
⁴¹ Shanghai Changzheng Hospital, Shanghai Neurosurgical Institute, No. 415, Fengyan Road, Huangpu District, Shanghai 200003, China.
⁴² Huashan Hospital, Fudan University, No. 12, Urumqi Middle Road, Jing'an District, Shanghai 200044, China.

PMID: 35992894
PMCID: PMC9386849
DOI: 10.1177/17562864221114357

Review

Chinese guideline on the application of anti-seizure medications in the perioperative period of supratentorial craniocerebral surgery

Shuli Liang et al. Ther Adv Neurol Disord. 2022.

. 2022 Aug 16:15:17562864221114357.

doi: 10.1177/17562864221114357. eCollection 2022.

Authors

Affiliations

¹ Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No. 56 Nanlishi Road, Xicheng District, Beijing 100045, China.
² Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
³ Xijing Hospital of Airforce Medical University, Xi'an, China.
⁴ Nanfang Hospital, Southern Medical University, Guangzhou, China.
⁵ Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
⁶ Xiangya Hospital, Central South University, Changsha, China.
⁷ Sanbo Brain Hospital, Capital Medical University, Beijing, China.
⁸ Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China.
⁹ Tianjin Medical University General Hospital, Tianjin, China.
¹⁰ Department of Neurosurgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.
¹¹ Jiangsu Provincial People's Hospital, Nanjing, China.
¹² Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
¹³ The Affiliated Hospital, Jiangnan University, Wuxi, China.
¹⁴ Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
¹⁵ Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China.
¹⁶ General Hospital of Northern Theater Command, Shenyang, China.
¹⁷ Shanghai Changzheng Hospital, Shanghai Neurosurgical Institute, Shanghai, China.
¹⁸ Peking Union Medical College Hospital, Beijing, China.
¹⁹ The First Affiliated Hospital, Hainan Medical University, Haikou, China.
²⁰ Shanxi Provincial People's Hospital, Taiyuan, China.
²¹ Peking University First Hospital, Beijing, China.
²² Children's Hospital of Fudan University, Shanghai, China.
²³ First Affiliated Hospital, Harbin Medical University, Harbin, China.
²⁴ Children's Hospital of Soochow University, Suzhou, China.
²⁵ Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China; Institute of Epilepsy, Shandong University, Jinan, China.
²⁶ Huashan Hospital, Fudan University, Shanghai, China.
²⁷ The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China.
²⁸ The Second Hospital of Hebei Medical University, Shijiazhuang, China.
²⁹ The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
³⁰ The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
³¹ The Southwest Hospital, Army Medical University, Chongqing, China.
³² Lanzhou University Second Hospital, Lanzhou, China.
³³ Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
³⁴ The First Hospital of Jilin University, Changchun, China.
³⁵ Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China; Key Laboratory of Major Disease in Children, Ministry of Education, Beijing, China.
³⁶ The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei, China.
³⁷ Xuanwu Hospital, Capital Medical University, Beijing, China.
³⁸ West China Hospital, Sichuan University, Chengdu, China.
³⁹ China Association Against Epilepsy, No. 135 Xizhimen Wai Avenue, Beijing 100044, China.
⁴⁰ Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring West Road, Fengtai District, Beijing 10070, China.
⁴¹ Shanghai Changzheng Hospital, Shanghai Neurosurgical Institute, No. 415, Fengyan Road, Huangpu District, Shanghai 200003, China.
⁴² Huashan Hospital, Fudan University, No. 12, Urumqi Middle Road, Jing'an District, Shanghai 200044, China.

PMID: 35992894
PMCID: PMC9386849
DOI: 10.1177/17562864221114357

Abstract

Seizures are a common symptom of craniocerebral diseases, and epilepsy is one of the comorbidities of craniocerebral diseases. However, how to rationally use anti-seizure medications (ASMs) in the perioperative period of craniocerebral surgery to control or avoid seizures and reduce their associated harm is a problem. The China Association Against Epilepsy (CAAE) united with the Trauma Group of the Chinese Neurosurgery Society, Glioma Professional Committee of the Chinese Anti-Cancer Association, Neuro-Oncology Branch of the Chinese Neuroscience Society, and Neurotraumatic Group of Chinese Trauma Society, and selected experts for consultancy regarding outcomes from evidence-based medicine in domestic and foreign literature. These experts referred to the existing research evidence, drug characteristics, Chinese FDA-approved indications, and expert experience, and finished the current guideline on the application of ASMs during the perioperative period of craniocerebral surgery, aiming to guide relevant clinical practice. This guideline consists of six sections: application scope of guideline, concepts of craniocerebral surgery-related seizures and epilepsy, postoperative application of ASMs in patients without seizures before surgery, application of ASMs in patients with seizures associated with lesions before surgery, emergency treatment of postoperative seizures, and 16 recommendations.

Keywords: anti-seizure medications (ASMs); craniocerebral surgery-related epilepsy; craniocerebral surgery-related seizure; guideline.

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Conflict of interest statement

Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

**Figure 1.**
Flow-chart of anti-seizure medications administration in perioperative period of patients with craniocerebral surgery. ASM, anti-seizure medications.

**Figure 2.**
Flow-chart of management for generalized convulsive status epilepticus after craniocerebral surgery. The recommendations were given according to relevant Chinese and English literatures, which were evaluated and graded based on the Oxford Center for Evidence-based Medicine Levels of Evidence (2009).

See this image and copyright information in PMC

References

1. Greenhalgh J, Weston J, Dundar Y, et al.. Antiepileptic drugs as prophylaxis for postcraniotomy seizures. Cochrane Database Syst Rev 2020; 4: CD007286. - PMC - PubMed
1. Liang S, Zhang J, Zhang S, et al.. Epilepsy in adults with supratentorial glioblastoma: incidence and influence factors and prophylaxis in 184 patients. PLoS ONE 2016; 11: e0158206. - PMC - PubMed
1. Yao Z, Hu X, You C. The incidence and treatment of seizures after cranioplasty: a systematic review and meta-analysis. Br J Neurosurg 2018; 32: 489–494. - PubMed
1. Spencer R, Manivannan S, Sharouf F, et al.. Risk factors for the development of seizures after cranioplasty in patients that sustained traumatic brain injury: a systematic review. Seizure 2019; 69: 11–16. - PubMed
1. National Neurosurgery Epilepsy Prevention and Treatment Cooperative Group. Guidelines for the prevention and treatment of perioperative and post-traumatic epilepsy in neurosurgery (Draft). Zhong Hua Shen Jing Ke Za Zhi 2006; 5: 1189–1192.

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Chinese guideline on the application of anti-seizure medications in the perioperative period of supratentorial craniocerebral surgery

Affiliations

Chinese guideline on the application of anti-seizure medications in the perioperative period of supratentorial craniocerebral surgery

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

LinkOut - more resources

Full Text Sources