Department of Neurosurgery, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark and BRIDGE (Brain Research-Interdisciplinary Guided Excellence), Odense, Denmark; OPEN - Odense Patient Data Explorative Network, J. B. Winsløws Vej 9a, Odense, Denmark.
Department of Clinical Medicine, Torsby Hospital, Sweden.
Clin Neurol Neurosurg. 2020 Jun;193:105779. doi: 10.1016/j.clineuro.2020.105779. Epub 2020 Mar 10.
Several risk factors have been shown to be associated with pre- and postoperative seizures in patients undergoing neurosurgical intervention for meningiomas and other primary brain tumors. This study aimed to identify risk factors associated with pre- and postoperative seizures in patients undergoing surgery for brain metastases (BM).
286 patients who had undergone neurosurgical resection for brain metastases between 2007 and 2015 were included in this single-center retrospective cohort. Seizure incidence and patient characteristics were recorded. Univariate and multivariate logistic regression was performed for both pre- and postoperative seizures.
16.8 % of patients presented with seizures before surgical intervention, and a further 7.7 % of patients developed seizures within 3 months of surgical resection of BM. Patient age, cerebellar location, large tumor size, and headache were negatively correlated with pre-operative seizures, whereas parietal location was positively correlated. Surgery for recurrent tumor was positively correlated with newly developed seizures after surgery.
Age, cerebellar location, large tumor size, and headache were negatively correlated with development of seizures while parietal location was found to be a risk factor. Lower age and resection of recurrent tumors was correlated with an increased risk of developing postoperative seizures. There was no correlation between type of primary tumor and development of seizures.
几项风险因素已被证明与接受神经外科手术干预脑膜瘤和其他原发性脑肿瘤的患者的术前和术后癫痫发作有关。本研究旨在确定与接受脑转移瘤（BM）手术的患者的术前和术后癫痫发作相关的风险因素。
本单中心回顾性队列纳入了 2007 年至 2015 年间接受神经外科切除术治疗脑转移瘤的 286 名患者。记录了癫痫发作的发生率和患者特征。对术前和术后癫痫发作进行了单变量和多变量逻辑回归分析。
16.8%的患者在手术干预前出现癫痫发作，另有 7.7%的患者在 BM 手术切除后 3 个月内出现癫痫发作。患者年龄、小脑位置、肿瘤体积大、头痛与术前癫痫发作呈负相关，而顶叶位置与术前癫痫发作呈正相关。对于复发性肿瘤的手术与术后新发癫痫发作呈正相关。
年龄、小脑位置、肿瘤体积大、头痛与癫痫发作的发生呈负相关，而顶叶位置是一个危险因素。年龄较小和切除复发性肿瘤与术后癫痫发作的风险增加相关。原发性肿瘤的类型与癫痫发作的发生之间无相关性。
