Supratentorial Gliomas Early Postoperative Epilepsy Risk Factor Analysis

Objective To analyse the result of the predisposing of factors of post-operativeepilepsia in patients with glioma with，s Univariate analysis and Logistic regression. Toexplore the predisposing factors， and put forward the corresponding preventivemeasures，in order to improve the postoperative quality of life of patients，reduce thepsychological and family burden of patients.Method The clinical data of256patients who receive craniotomy for glioma in ourdepartment from January2010to November2011was analyzed retrospectively with sUnivariate analysis and Logistic regression，with P <0.05for the difference wasstatistically significant. Pearson x2test would be used between count data. Logisticregression would be used in multiple factors analysis. Among them: Orderlyclassification variables including age（＜15year，15to59year，＞59year），tumor size（＜3cm，3to5cm，＞5cm），tumor cavity bleeding(none, A little bleeding, Morebleeding or hematoma cavity), Postoperative edema(no, a little swelling without midlineshift or lateral ventricle pressure, large edema with midline shift or lateral ventriclepressure), pathological grade(GradeⅠ-Ⅱ，GradeⅢ，GradeⅣ)；Binary classificationvariables including gender(male/female)、Preoperative epilepsy history(yes/no) andremoval of the scope(whole resection/not all cut)；polytomous variable including tumorlocation（Frontal lobe, temporal lobe, parietal lobe, occipital lobe, other）and surgicalprocedures（Frontal approach、Temporal approach、Frontotemporal approach、The temporal head the road、other）.Result The epilepsia of post-operative occur in16cases,a rate of6.25%, included7cases of partial seizures(43.75％),9cases generalized tonic-clonicseizures(56.25％),1case Status epilepticus（6.25％). Age less than15years of age0cases（0/10，0.00％）,14cases of15to59years old（14/206，6.80％）, More than59in2cases （2/40，5.00％）,12cases were male（12/161，7.45％）,4cases were female（4/95，4.21％）;Univariate analysis showed that history of pre-operativeepilepsy,location,post-operative edema and tumor cavity bleeding were identified asrisk factors for post-operative epilepsia in glioma patients. Logistic regression analysisshowed that history of pre-operative epilepsy,post-operative edema and tumor cavitybleeding were risk factors,and the value of OR were,4.339、3.07、2.771, respectively.；There are11cases with early postoperative epilepsy patients with epilep medical history（11/101，10.90％），5cases with early postoperative epilepsy patients without epilepmedical history（5/155，3.23％）；9patients with tumors located in the frontal lobe（9/112，％），1case Located in the temporal lobe（1/64，1.56％），6cases in arietallobe（6/28，21.43％），0cases in occipital lobe（0/11，0.00％），41cases in other location（0/41，0.00％）；9cases with Pathological tips for Grade Ⅰ-Ⅱ leve（l9/131，6.87%），5cases for GradeⅢlevel（5/63，7.94%）,2cases for GradeⅣ level（2/62，3.23%）；5cases with tumor diameter less than3cm（5/88，5.68%），7cases with3to5cm（7/108，6.48%）,4cases with with tumor diameter more than5cm（4/60，6.67%)；7cases of frontal approach（7/110，6.36%），Temporal approach in0（0/23，0.00%），3cases of frontotemporal approach（3/55，5.46%），Temporoparietal0cases into theroad（0/27，0.00%），Other6cases into the road（6/41，14.63%）；Tumor cut all the10case（s10/187，5.35%），6cases of partial nephrectomy（6/69，8.70%）；1case Withoutpostoperative brain edema （1/57，1.75%），a little swelling without midline shift or lateral ventricle pressure in8case（8/146，5.48%），large edema with midline shift orlateral ventricle pressure in7case（7/53，13.21%）； no bleeding in6case（6/133，4.51%），A little bleeding in4case（4/99，4.04%）More bleeding or hematoma cavityin6case（6/24，25.00%）.The result of the Univariate analysis reveal：Preoperativeepilepsy history (Χ2=6.132,P<0.05)、tumor location (Χ2=17.485,P<0.05)、Postoperativeedema (Χ2=6.132,P<0.05)and tumor cavity bleeding (Χ2=30.310,P<0.05)is associatedwith supratentorial glioma early postoperative seizures (P<0．05)，but has nothing to dowith patient age、gender、pathological grade、tumor size、operative route or removal ofdegree. more Logistic regression show，Preoperative epilepsy history (OR=4.339，95％CI=1.422～13.246；P=0．010)、tumor location (OR=1.346，95％CI=1.419～10.82；P=0．012)及cavity bleeding (OR=2.771，95％CI=1.361~5.643；P=0．005) is risk factors.Conclusion Pre-operative epilepsy,post-operative edema and tumor cavity bleedingwere risk factors. For this patients, we should pay special attention to them earlypostoperative prophylactic antiepileptic for drug therapy, as far as possible to reduce theincidence of early postoperative epilepsy.