1. Seizure outcomes of supratentorial brain tumor resection in pediatric patients
- Author
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Fadi S Saadeh, Nolan D Rea, Mark D. Krieger, and Edward Melamed
- Subjects
Male ,Cancer Research ,medicine.medical_specialty ,Tumor resection ,Supratentorial region ,Preoperative care ,Neurosurgical Procedures ,Resection ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Seizures ,medicine ,Humans ,Single institution ,Child ,Retrospective Studies ,Univariate analysis ,business.industry ,Brain Neoplasms ,Supratentorial Neoplasm ,Supratentorial Neoplasms ,Retrospective cohort study ,Prognosis ,Surgery ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Female ,Neurology (clinical) ,business ,Pediatric Neuro-Oncology ,030217 neurology & neurosurgery - Abstract
BACKGROUND: This study aims to identify the prevalence of and risk factors for seizure development after supratentorial brain tumor resection in pediatric patients. This could be used to guide the postoperative management and usage of anti-epileptic drugs (AEDs). METHODS: Retrospective study was conducted for patients between 0 and 21 years with supratentorial tumor resection between 2005 and 2015 at a single institution. RESULTS: Two hundred patients (114 males/86 females) were identified. Median age at resection (±SD) was 9.025 ± 5.720 years and mean follow-up was 4 ± 2 years. Resection was gross total in 82 patients (41%) and partial in 118 patients (59%); 66 patients (33%) experienced preoperative seizures, and 67 patients (34%) experienced postoperative seizures; 18 patients (27%) had early seizures, and 49 patients (73%) had late seizures. Univariate analysis identified risk factors for postoperative seizures as: preoperative seizures (P < 0.001), age less than 2 years (P = 0.003), temporal location (P < 0.001), thalamic location (P = 0.017), preoperative hyponatremia (P = 0.017), World Health Organization grade (P = 0.008), and pathology (P = 0.005). Multivariate regression identified 5 robust risk factors: temporal location (odds ratio [OR] 4.7, 95% CI: 1.7–13.3, P = 0.003), age 0.05). CONCLUSIONS: This study reveals 5 risk factors for postoperative seizures after resection of supratentorial tumors. These factors should be considered in postoperative management of these patients.
- Published
- 2018