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01-11-2019 | Glioma | Clinical Study

Risk factors for intraoperative stimulation-related seizures during awake surgery: an analysis of 109 consecutive patients

Authors: Giannantonio Spena, Elena Roca, Francesco Guerrini, Pier Paolo Panciani, Lorenzo Stanzani, Andrea Salmaggi, Sabino Luzzi, Marco Fontanella

Published in: Journal of Neuro-Oncology | Issue 2/2019

Abstract

Introduction

During surgery for lesions in eloquent areas the goal is to achieve the widest resection possible, without loss of neurological function. Intraoperative seizures may lead to abandonment of the procedure or damages to the patient. Awareness regarding the predictors of IOS would help the surgeon. The aim of this retrospective study was to identify the factors associated with the occurrence of IOS in patients who underwent awake surgery for removal of gliomas in eloquent areas.

Methods

This was a retrospective analysis of prospectively collected data of 109 patients who underwent awake craniotomy between January 2010 and December 2017 for removal of gliomas. IOS were defined as tonic–clonic seizures or loss of consciousness resulting in communication difficulties with the patient occurring during cortical and subcortical mapping.

Results

A total of 109 patients were included in this study and IOS occurred in 9 (8.2%) patients. Demographic and clinical factors were comparable between patients with and without IOS. In the IOS group, 7 (77.8%) patients had seizures preoperatively and 4 (57.1%) were on more than one perioperative antiepileptic drugs (AED).

Conclusions

The current series add some hints to the poorly studied IOS risk during awake surgery. The risk of IOS appears to be relatively higher in patients with anteriorly located tumors and in patients operated without intraoperative brain activity monitoring and different patterns of stimulation for language and sensory-motor mapping. Further studies are needed to clarify the role of intraoperative techniques.

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Title: Risk factors for intraoperative stimulation-related seizures during awake surgery: an analysis of 109 consecutive patients
Authors: Giannantonio Spena
Elena Roca
Francesco Guerrini
Pier Paolo Panciani
Lorenzo Stanzani
Andrea Salmaggi
Sabino Luzzi
Marco Fontanella
Publication date: 01-11-2019
Publisher: Springer US
Keywords: Glioma
Craniotomy
Antiepileptic Drugs
Glioma
Glioma
Antiepileptic Drugs
Published in: Journal of Neuro-Oncology / Issue 2/2019
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-019-03295-9

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Risk factors for intraoperative stimulation-related seizures during awake surgery: an analysis of 109 consecutive patients

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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