Anaesthesia for epilepsy surgery

Abstract

Epilepsy is the most common serious neurological disease, with a prevalence commonly quoted as 5-10 cases per 1000 persons. Incidence varies due to a number of factors. In developed countries, it has been found to be around 50 cases per 100,000 persons per year. In developing countries, the incidence is higher (of the order of 100-190/100,000/year) for reasons which are not entirely clear. Thus from an anesthetic perspective, it is important to understand the issues of safe management of epileptics in the peri-operative period.

A seizure is any abnormal clinical event caused by electrical discharge from the brain, while epilepsy is a tendency to have seizures and considered as a symptom of the brain rather than a disease itself. A single seizure is not epilepsy but an indication for investigation. The recurrence of attacks after the first one approach about 70% in the first year mainly occurs in the first or second month . Approximately 10% of the population has a single convulsive episode during their lifetime. In this situation, the use of anticonvulsants is not indicated. After the occurrence of a second seizure, the diagnosis of epilepsy is confirmed, initiating then the routine treatment with antiepileptic drugs .