Post-operative seizure prophylaxis in gliomas

The role of prophylactic anti-epileptic drugs (AEDs) in patients with brain tumours in the post-operative period is a vexed issue. Post-operative prophylaxis can be dichotomised into short term peri-operative prophylaxis lasting 1–2 weeks and longer-term prophylaxis lasting several months. The choice of drug, dose and length of treatment differs institution to institution and surgeon to surgeon. Over the last decade levetiracetam has really become the standard first line treatment offering some treatment consistently, however this is driven largely by expert opinion rather than high-level evidence data (1).