I haven't seen any comments about problems with seizures post craniotomy. And, I am assuming they are not an issue with the other techniques.
Seizures have been my biggest post operative issue. Seizures are what I fear most and what I've placed most of my emphasis on controlling and follow-up since my rupture in 1969. I was given Dilantin post op, took it for 3 most, taken off of it. Approximately 1 year later I had my first grand mal seizure and was hospitalized for several days. I've taken anti convulsants since then (Dilantin for the first 16 years and Tegretol ever since.) I've probably had 8 seizures total. My last seizure was about 20 years ago but the most recent EEG suggested that I am still at risk so I continue to take Tegretol. Hopefully, I'll NEVER have another.
I'm curious about the experiences of others and would appreciate your sharing them with me.
A craniotomy requires open brain surgery and other sealing techniques are internal to the blood vessel itself. This would explain the seizure difference in the different groups. I should also add that a bleed internal to the brain tissue can also be responsible for seizures. My wife was fortunate to be weened off of Dilantin within a year of her surgery. I don't often read about a suvivior from so long ago. God bless and continued good health.
I'm glad to know that your seizures are also well controlled.
My experience was some what similar in as yours in that I've had long periods with out seizures. After the first one I had a 6 year period of no seizures then two in the same night. Then another 5 year period with no seizures followed by several within a few months of each other. Two of them were in quite public places - one in a restaurant and another in a hotel lobby. I'm fortunate that I only had one injury with a seizure. I fell in the kitchen and hit my head where my bone flap protrudes. It was only a black eye but everyone was curious about what happened to me. I got lots of attention from my co-workers. :-)
Needless to say, I will stay on the medicine to avoid them. I love the freedom that being seizure free provides.
I have been dealing with seizures since my rupture(10/06/08). Several the day of my rupture and on and off since my surgery. I have been hospitalized several times since then for them grans, petits I had been on Kepra for almost 3yrs and dilantin and now topomax. I mainly have the cranial ones now they pass quickly non convulsive. I have had to slow myself down and realize that I am not in a sprint I am in a marathon a liftime marathon. I really did'nt think anyone else was dealing with or has dealt with this issue. I have been seizure free for 42 days as of today. This last increase might be the right amount. keeping a positve outlook on it. Thank you for sharing it lets me know that there is a light at the end of this tunnel. I am very hopeful that I too will be seizure free for long periods of time if not completly free. Have a wonderful day
I'm so happy to hear that the number of seizure free days is increasing for you. I will pray that you will may become totally free for the grand mals are so draining and scary - at least for me. I recall that one of my big lessons was to learn to slow down, I was still a teenager when I had my rupture. And, sometimes now, I have to remind myself that it's okay to be a bit slower than others. These days I often refer to myself as a turtle.
It's good to know that you have cats that can warn you and help to keep you out of danger. My seizures have always been without warning so they're quite scary. I continue to give thanks for the years of being seizure free and will continue to pray that you and me and Enis, and everyone else who suffers from these may one day be totally free of them.
A quick question regarding the seizures it takes me a bit of time to get over them espescially the grands I tend to be sore afterwards mainly my right side that is my stroke side and I sleep for a few days. But I don't really remember what happened just small fragments of the seizures it's like I loose chunks of time. Can you recall this happening to you. I am not sure if it is the condition or the short term memory or the drugs they have given me in the hospital??? I was 43 when mine ruptured it was an abrupt stop in life.The hardest lessons has been to slow down and except that I have had somthing traumatic happen to me . Thank You And My Prays are with You as well
I found the following article on line and according to this article seizures are more common following clipping, however if your aneurysm was on the MCA, there is a higher incidence of seizures in both clipping or coiling.
JulieNH
Epilepsy after subarachnoid hemorrhage: the frequency of seizures after clip occlusion or coil embolization of a ruptured cerebral aneurysm.
Hart Y; Sneade M; Birks J; Rischmiller J; Kerr R; Molyneux A Department of Neurology, Royal Victoria Infirmary, Newcastle Upon Tyne;
Object The aim of this study was to determine the probability of seizures after treatment of a ruptured cerebral aneurysm by clip occlusion and coil embolization, and to identify the risks and predictors of seizures over the shortand long-term follow-up period. Methods The study population included 2143 patients with ruptured intracranial aneurysms who were enrolled in 43 centers and randomly assigned to clip application or coil placement. Those patients suffering a seizure were identified prospectively at various time points after randomization, as follows: before treatment; after treatment and before discharge; after discharge to 1 year; and annually thereafter. Results Two hundred thirty-five (10.9%) of the 2143 patients suffered a seizure after randomization; 89 (8.3%) of 1073 and 146 (13.6%) of 1070 in the endovascular and neurosurgical allocations, respectively (p = 0.014). In 19 patients the seizure was associated with a rehemorrhage. Of those patients who underwent coil placement alone, without additional procedures, 52 suffered a seizure, and in the group with clip occlusion alone, 91 patients suffered a seizure. The risk of a seizure after discharge in the endovascular group was 3.3% at 1 year and 6.4% at 5 years. In the neurosurgical group it was 5.2% at 1 year and 9.6% at 5 years. The risk of seizure was significantly greater in the neurosurgical group at both 2 years and at up to 14 years (p = 0.005 and p = 0.013, respectively). The significant predictors of increased risk were as follows: neurosurgical treatment allocation, hazard ratio (HR) 1.64 (95% CI 1.19-2.26); younger age, HR 1.54 (95% CI 1.14-2.13); Fisher grade > 1 on CT scans, HR 1.34 (95% CI 0.62-2.87); delayed ischemic neurological deficit due to vasospasm, HR 2.10 (95% CI 1.49-2.94); and thromboembolic complication, HR 5.08 (95% CI 3.00-8.61). A middle cerebral artery (MCA) aneurysm location was also a significant predictor of increased risk in both groups; the HR was 2.23 (95% CI 1.57-3.17), with the probability of seizure at 6.1% and 11.5% at 1 year in the endovascular and neurosurgery groups, respectively. Conclusions The risk of seizures after coil embolization is significantly lower than that after clip occlusion. An MCA aneurysm location increased the risk of seizures in both groups. http://reference.medscape.com/medlin...189?src=nlbest
Thanks for the article. This information is quite illuminating. I had a rupture of the PCA and a subarachnoid hemorrhage. It took two surgeries, approximately two weeks apart, to completely repair it.
Because of the infrequency of my seizures (and because of the way people tend to react when you say epilepsy), I've usually described myself as having a "seizure disorder" when it's necessary to bring it up.
My seizures have come on suddenly and without warning. I remember that mental spinning, out of control feeling. I don't think they've lasted that long - but I can't remember how much time passed each time. The scariest one occurred when we were in the car driving on a highway. I remember telling my husband "seizure Sam". He had to stop me from opening the car door because I wanted to get out of the car.
Because of their infrequency plus my having additional unruptured aneurysms and, the nature of the seizures that I've had, I have always gone to the hospital by ambulance. I've always lived near a major medical facility because of my aneurysms so, with one exception, by the time I got to the hospital the episode was over. But, I remember that after each one, I felt tired and I slept for extended periods. They would sometimes keep me for a couple of days and often that's when they would do a new study. You could do this in the "old days".
I have other conditions for which I've been given medications that I've asked the doctor to discontinue because they affect my thinking and slow my speaking. Please try working with your doctor to adjust your meds if your feel like a "zombie". You may have to be strong about it. I have done so.
My body usually needs about 1/2 of what everyone else does. At first it was difficult to get the doctors to understand that. But now, I've succeeded. I take 200 mg Tegretol 2x a day. That's very low but it works for me. I reduced it about 12 years ago because I was feeling so bad. After 1 month since I'd not had a problem, I went to the doctor who was not all pleased with me. So, I asked her to check my levels. I told her if I was within the therapeutic levels, I would continue with the lower dose but that I would go back to the higher level if needed. I was within the therapeutic level at the time, although just barely. I've continued without problems on this dosage since then. My level has come up.
I've moved twice since then and each time I saw a new doctor they've been shocked by my success on this low dosage. I continue to take it because the last EEG suggested that there is still some risk. And, I like being able to drive and travel.
I've used this lesson to work with my other doctors to get dosages of other medications lowered successfully, too.