REVIEW   

Journal of Neurosurgical Sciences 2019 June;63(3):301-7

DOI: 10.23736/S0390-5616.16.03880-7

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Intraoperative seizures and seizures outcome in patients undergoing awake craniotomy

Yang YUAN, Zhou PEIZHI, Wang XIANG, Liu YANHUI, Liang RUOFEI, Jiang SHU, Mao QING ✉

Department of Neurosurgery, West China Hospital, Si Chuan University, Chengdu, China

INTRODUCTION: Awake craniotomies (AC) could reduce neurological deficits compared with patients under general anesthesia, however, intraoperative seizure (IOS) is a major reason causing awake surgery failure. The purpose of the study was to give a comprehensive overview the published articles focused on seizure incidence in AC.
EVIDENCE ACQUISITION: Bibliographic searches of the Embase, Medline, were performed to identify articles and conference abstracts that investigated the IOS frequency of patients underwent AC.
EVIDENCE SYNTHESIS: Twenty-five studies were included in this meta-analysis. Among the 25 included studies, one was randomized controlled trials and 5 of them were comparable studies. The pooled data suggested the general IOS rate for patients with AC was 8% (fixed effect model), sub-group analysis identified IOS rate for glioma patients was 8% and low grade patients was 10%. The pooled data showed early seizure rates of AC patients was 11% and late seizure rates was 35%.
CONCLUSIONS: This systematic review and meta-analysis shows that AC is a safe technique with relatively low IOS occurrence. However, few RCTs were available, and the acquisition of further evidence through high-quality RCTs is highly recommended.

KEY WORDS: Craniotomy - Glioblastoma - Seizures - Brain neoplasms - Glioma