Analysis Of Risk Factors For Perioperative Seizures In Moyamoya Disease

Research background:Moyamoya disease has a low prevalence in the natural population and a high risk of cerebral ischemic stroke and cerebral hemorrhage.Although intracranial and extracranial vascular bypass can improve symptoms and reduce the risk of hemorrhage in patients with MMD,postoperative complications such as stroke,seizures,and hyperperfusion still exist.Seizures are a common complication during the perioperative period in MMD patients,which can lead to temporary or irreversible impairment of brain function and require attention,with few studies available.Objective:The purpose of this paper is to investigate the risk factors for perioperative seizures in patients with MMD,and then to provide a theoretical basis for reducing the incidence of perioperative seizures in MMD by combining published literature and experiences from home and abroad.Materials and Methods:During the period from January 1,2016 to June 30,2020,in the Department of Neurosurgery,First-Affiliated Hospital,Nanchang University,421 patients with moyamoya disease underwent 499 direct and indirect/combined intracranial-extracranial revascularization-reconstructive procedures.The clinical history and imaging data of the cases were retrospectively compiled and analyzed using SPSS 22 version statistical software for data processing and a combination of univariate and multifactorial analyses to determine which factors were associated with and independent risk factors for perioperative seizures during intracranial-extracranial revascularization for moyamoya disease.Result:1.The incidence of perioperative seizures in patients with MMD who underwent intracranial and extracranial vascular bypass in this study was 5.81%(29/499 cases).2.Univariate analysis showed that history of infarction only,postoperative electrolyte disturbance,and postoperative stroke(postoperative hemorrhage),were factors associated with perioperative seizures in patients with MMD.3.Multifactorial analysis suggested that postoperative electrolyte disturbance and postoperative stroke(postoperative bleeding)were independent risk factors for perioperative seizures in patients with MMD.Conclusion:1.Postoperative electrolyte disturbances and postoperative stroke(postoperative hemorrhage)are independent risk factors for perioperative seizures in MMD patients who undergo intracranial and extracranial vascular bypass surgery.2.Patients with moyamoya disease receiving prophylactic use of antiepileptic drugs do not have a reduced risk of perioperative seizures.