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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Why Is Levipil Syrup Given After Burr Hole Surgery?

MY FATHER HAS UNDERGONE A HEAD SURGERY CALLED BURR HOLE. ACCORDING TO THE NEURO SURGEON HE IS SUFFERING FROM BRAIN ATROPHY AND SOME FLUID WAS ALSO FOUND IN THE EMPTY SPACE UNDER THE SKULL WHICH WAS BILATERAL IN NATURE. HE IS BETTER THEN BEFORE AND WAS GIVEN LEVIPIL SYRUP AS A MEDICINE BUT HE DOES NOT HAVE ANY SEIZURE AND ALL. SO I JUST WANTED TO KNOW WHY HE WAS GIVEN LEVIPIL SYRUP. PLEASE HELP
Thu, 4 Dec 2014
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Neurologist 's  Response
I read your query and I understand your concern.
Since you mention burr hole surgery, I am assuming his probable diagnosis is a subdural hematoma. That means blood along the surface of the brain. That presence of blood (some of it could be still left after surgery) could irritate the brain surface and cause abnormal discharges, hence seizures. It may not happen at all but there is an increased risk compared to the normal population. That is why I presume the neurosurgeon has prescribed Levipil even though he has never had a seizure.
Whether I agree with that is another issue. Generally I don't start antiepileptics unless there has been a seizure. But there is not always consensus on every issue between doctors especially on issues like this where it's a matter of risk percentages not of certainties, doesn't necessarily mean there's a "good" and a "bad" doctor.
Also there might be factors you might not know like minor partial seizures you have missed or changes in EEG. So you should discuss your doubts with him as well.
Hope to have been of help.
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Why Is Levipil Syrup Given After Burr Hole Surgery?

I read your query and I understand your concern. Since you mention burr hole surgery, I am assuming his probable diagnosis is a subdural hematoma. That means blood along the surface of the brain. That presence of blood (some of it could be still left after surgery) could irritate the brain surface and cause abnormal discharges, hence seizures. It may not happen at all but there is an increased risk compared to the normal population. That is why I presume the neurosurgeon has prescribed Levipil even though he has never had a seizure. Whether I agree with that is another issue. Generally I don t start antiepileptics unless there has been a seizure. But there is not always consensus on every issue between doctors especially on issues like this where it s a matter of risk percentages not of certainties, doesn t necessarily mean there s a good and a bad doctor. Also there might be factors you might not know like minor partial seizures you have missed or changes in EEG. So you should discuss your doubts with him as well. Hope to have been of help.