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Seizure risk after a craniotomy, and the medicines used | CION Cancer Clinics
Some people have a seizure, or fit, after a craniotomy, because surgery can irritate the nearby brain. It is more likely if you had fits before the operation or the tumour sat in the outer brain. Many people are given an anti-seizure medicine such as levetiracetam. This page explains who is at higher risk, what the family should do during a fit and why the tablets must never be stopped on your own. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- Can you have a seizure after a craniotomy?
- What makes a seizure after brain surgery more likely?
- What should the family do if a seizure happens?
- Will you need medicine to prevent seizures?
- What do families wrongly believe about fits after surgery?
- How does seizure risk change daily life, and what can this page not tell you?
- Common questions about seizures after a craniotomy
The short answer
Can you have a seizure after a craniotomy?
Yes, some people do. Any operation on the brain can irritate the nearby brain tissue, and that irritation can set off a seizure, also called a fit. Many people never have one, and when one does happen it is usually controlled with medicine.
Why the brain reacts this way
Brain cells pass messages using tiny electrical signals. A tumour, the surgery itself, bleeding or swelling can disturb those signals for a while. A seizure is a sudden burst of that disturbed activity. It can look like shaking of an arm, a blank stare, odd feelings or a full fit with loss of awareness.
When seizures tend to happen
Some happen in the first days after surgery, while the brain is most swollen. Others come weeks or months later, as scar tissue forms where the operation was done. A seizure some time after surgery does not always mean the tumour has come back, but your team will want to check.
This page explains the general picture. Only your neurosurgeon or neurologist can tell you how likely a seizure is for you.Who is more likely
What makes a seizure after brain surgery more likely?
Your team weighs several things together. No single one decides it.
Seizures before surgery
If the tumour was first found because of a fit, the brain has already shown it can react this way. The chance of another is higher, at least for a time.
Where the tumour sits
Tumours in the outer layer of the brain, called the cortex, cause seizures more often than those deeper down or at the back of the head.
Often linked with
- The temporal lobe, near the ear
- The frontal lobe, behind the forehead
The type of tumour
Slow-growing gliomas and some meningiomas are known for causing fits. Your pathology report, the tissue test done after surgery, names the type.
What happens after the operation
Bleeding, swelling, infection, low salt levels in the blood and poor sleep can all lower the threshold for a fit. So can missed doses of medicine.
Not sure whether this applies to you?
Ask an oncologistAt home
What should the family do if a seizure happens?
Keep them safe
Move sharp or hard objects away. Put something soft under the head. Do not hold them down, and do not try to stop the shaking.
Nothing in the mouth
Do not put a spoon, finger, keys or water in the mouth. A person cannot swallow the tongue. Loosen anything tight around the neck.
Note the time
Look at a clock when it starts. If you can, take a short video on your phone. The doctor will find it very useful.
Turn them on their side
When the shaking stops, roll them onto their side so saliva can drain. Stay with them. Confusion and sleepiness afterwards are common.
!
When a seizure cannot wait
Call 108 or go to the nearest emergency department straight away if a fit does not stop within a few minutes, if one fit follows another without waking in between, if they are injured, or if breathing does not return to normal. Tell the doctors they recently had brain surgery. Do not wait to phone the surgeon first.
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Anti-seizure medicines
Will you need medicine to prevent seizures?
Many people are given an anti-seizure medicine around the time of a craniotomy. Whether you need one, and for how long, is decided by your neurosurgeon. It depends on whether you have had fits and on the tumour.
Medicines you may see on your prescription
Levetiracetam, sold in India as Levipil or Keppra, is used often. Others include phenytoin (Eptoin), sodium valproate (Valparin or Encorate) and lacosamide (Lacosam). The name on the strip may differ from the one on the discharge summary, so check with the pharmacist.
Side effects to report
Sleepiness and dizziness are common at first. Levetiracetam can change mood in some people, making them irritable, low or angry. Tell the team about a rash, unusual bruising or any change in behaviour that worries the family.
Never stop on your own
Stopping suddenly can bring on a fit, even in someone who never had one. Only the doctor who prescribed it should change the dose or stop it.
Bring every medicine strip to your follow-up visit, including any from another doctor.Commonly believed
What do families wrongly believe about fits after surgery?
"One seizure means the operation failed."
A fit after brain surgery is a known effect of the brain healing. It does not by itself mean something went wrong. It does mean the team needs to know, so tell them the same day.
"He feels fine, so he can stop the tablets."
Feeling well is often a sign the medicine is working. Stopping it without advice is one of the most common reasons for a fit after discharge.
"Hold the person down and put a spoon in the mouth."
This causes broken teeth and injuries to both people. Keep them safe, keep the mouth empty and turn them on their side once the shaking stops.
"Fits are caused by spirits or the evil eye."
A seizure is an electrical disturbance in the brain. Delaying hospital care for rituals can put a life at risk.
Being straight with you
How does seizure risk change daily life, and what can this page not tell you?
For a while, a few precautions matter. The aim is to keep you safe if a fit happens without warning, not to keep you at home.
Driving, heights and water
Do not drive a car, bike or auto until your doctor says it is safe. Rules on driving after a seizure or brain surgery are strict. Avoid ladders, rooftops and swimming alone. Use a shower rather than a bucket bath in a locked bathroom, and leave the door unlocked.
Habits that help
Take the medicine at the same time each day. Sleep well, and avoid alcohol. A phone alarm helps an older parent who forgets doses.
What this page cannot tell you
It cannot tell you your own risk, how long you need medicine, or when you can drive again. Those depend on your scans, your tumour and your history of fits. Ask your neurosurgeon these three questions directly.
Questions we are asked
Common questions about seizures after a craniotomy
Is a seizure after craniotomy common?
It is a known effect, but most people do not have one. The chance is higher if you had fits before surgery or if the tumour was in the outer part of the brain. Your neurosurgeon can tell you whether your own risk is lower or higher than usual.
Why was I given seizure medicine when I never had a fit?
Some surgeons give it around the operation because the brain is most irritable then. Practice varies between surgeons and depends on the tumour. Ask whether the plan is to stop it later and who will decide that. Do not stop it yourself.
Can Levipil cause anger or low mood?
Yes, in some people levetiracetam causes irritability, anger or low mood. Families often notice it before the patient does. Tell the prescribing doctor. There are other medicines that can be used instead, but the switch must be planned by the doctor.
What if a dose is missed?
Follow the advice on your discharge sheet or ask the pharmacist. Do not take a double dose without checking. If doses are often missed, use a pill box and a phone alarm, and let one family member take charge of the tablets.
Does a fit months later mean the tumour is back?
Not always. Scar tissue where the operation was done can cause fits long after surgery. But a new or changed pattern of seizures should always be reported, and your team may ask for a scan to check what is going on.
Can I travel home to my district by bus or train?
Usually yes, once you are discharged, as long as someone travels with you. Carry your discharge summary and enough medicine for the journey and a few extra days. Ask the team whether a long trip is safe before you plan it.
Can I go back to work?
Many people do, once recovery allows. Jobs that involve driving, machines, heights or working alone need more care, and your doctor may advise changes for a while. Talk about your type of work at the follow-up visit rather than guessing.
Can seizure medicine be taken with chemotherapy or radiotherapy?
Often yes, but some anti-seizure medicines affect how other drugs work. Tell your oncologist every medicine you take, including Ayurvedic or herbal remedies. The doctors will check the combination and may change one of them if needed.
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Sources
- NHS — What to do if someone has a seizure
- NHS — Brain tumours
- Cancer Research UK — Brain tumours
- National Cancer Institute — Brain and spinal cord tumours
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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