Clinical Study On The Waveform Features Of Ambulatory Electroencephalogram And Epileptic Seizure Before And After Cranioplasty

Objective To investigate the clinical factors concerning epileptic seizures after cranioplasty(CP),and to discuss the predictive value of ambulatory electroencephalogram(aEEG)for post-cranioplasty seizures by analyzing the relationship between aEEG waveforms and epileptic seizures before and after CP.Methods We retrospectively analyzed the clinical and aEEG data of113 cranioplasties done from Augest 2012 to December 2016 in neurosurgery department of our hospital.113 patients were also divided into pre-cranioplasty epileptic seizure group and non-epileptic seizure group depending on whether seizure accured before CP,post-cranioplasty epileptic seizure incidence were compared.Patients in pre-cranioplasty epileptic seizure group were further divided into post-cranioplasty new epileptic seizure group and non-epileptic seizure group according to whether seizure happened after cranioplasty,gender,age,primary etiology,surgical site,skull defect area,duration of cranioplasty,interval time ofcraniectomy to cranioplasty were compared between two groups.Patients were divided into typical spike/sharp waveform group and atypical spike/sharp waveform group according to pre-cranioplasty aEEG,epileptic seizure incidence before and after cranioplasty were also compared.Results 1.The incidence of epileptic seizure after CP in the pre-cranioplasty epileptic seizure group was significantly higher than that in the preoperative non-epileptic seizure group(P <0.05).There were no significant statistical differences in gender,age,surgical site,skull defect area,duration of cranioplasty,interval time of craniectomy to cranioplasty between post-cranioplasty epileptic seizure group and non-epileptic seizure group(P> 0.05),while the primary etiology was statistically significant different in two groups(P <0.05).2.Both pre-cranioplasty and post-cranioplasty epileptic seizure rates of typical spike/sharp waveform group were significantly higher than those of the atypical spike/sharp waveform group(P <0.05).The positive predictive value of typical spike/sharp waveform pattern before CP for postoperative epileptic seizure was 54.00%,and the negative predictive value was 92.06%.Conclusions Patients with pre-cranioplasty epileptic seizures are prone to seizures after cranioplasty.Gender,age,surgical site,skull defect area,duration of cranioplasty,interval time of craniectomy and cranioplasty has no correlation with post-cranioplasty new epileptic seizures,but the primary etiology does.The typical spike/sharp waveform is closely relatedto epileptic seizures and has a certain predictive value for post-cranioplasty seizures.