Analysis of risk factors for epileptic seizure after combined revascularization in adult patients with moyamoya disease

doi:10.3969/j.issn.1672-6731.2022.07.007

Abstract

Abstract: Objective To summarize the clinical features of postoperative epileptic seizure in adults with moyamoya disease (MMD) treated with combined revascularization, and screen the related influencing factors. Methods Total 189 patients with MMD who underwent combined revascularization in Department of Neurosurgery of the First People's Hospital of Yunnan Province from January 2015 to June 2021 were included. Univariate and multivariate forward Logistic regression analysis was used to screen the influencing factors of epilepsy after combined revascularization in MMD patients. Results Logistic regression analysis showed preoperative seizure (OR=5.523, 95%CI:1.486-20.524; P=0.011), revascularization bypass vessel located in frontal lobe (OR=2.793, 95%CI:1.027-7.597; P=0.044), postoperative cerebral infarction (OR=9.025, 95%CI:2.121-38.404; P=0.003), cerebral hyperperfusion syndrome (OR=3.624, 95%CI:1.281-10.253; P=0.015) and intracranial hemorrhage (OR=5.646, 95%CI:1.219-26.142; P=0.027) were the risk factors of postoperative epileptic seizure in patients with MMD.Conclusions Preoperative seizure, revascularization bypass vessel located in frontal lobe, postoperative cerebral infarction, cerebral hyperperfusion syndrome and intracranial hemorrhage are the clinical risk factors of epileptic seizure in adult MMD patients, timely intervention of risk factors may reduce postoperative epileptic seizure in patients with MMD.

Key words: Moyamoya disease, Cerebral revascularization, Epilepsy, Postoperative complications, Risk factors, Logistic models

摘要： 目的总结烟雾病联合血管重建术后癫痫发作的临床特点并筛查相关影响因素。方法纳入云南省第一人民医院2015年1月至2021年6月收治的189例成人烟雾病联合血管重建术后患者，单因素和多因素前进法Logistic回归分析筛查联合血管重建术后癫痫发作的影响因素。结果 Logistic回归分析显示，术前有癫痫发作史（OR=5.523，95% CI：1.486~20.524；P=0.011）、桥血管位于额叶（OR=2.793，95% CI：1.027~7.597；P=0.044），以及术后并发脑梗死（OR=9.025，95% CI：2.121~38.404；P=0.003）、脑过度灌注综合征（OR=3.624，95% CI：1.281~10.253；P=0.015）和脑出血（OR=5.646，95% CI：1.219~26.142；P=0.027）是烟雾病患者术后癫痫发作的危险因素。结论术前有癫痫发作史、联合血管重建术桥血管位于额叶，以及术后并发脑梗死、脑过度灌注综合征和脑出血是成人烟雾病患者术后癫痫发作的危险因素，及时对危险因素进行干预，有可能减少术后癫痫发作。

关键词: 脑底异常血管网病, 脑血管重建术, 癫痫, 手术后并发症, 危险因素, Logistic模型

YANG Shuai-feng, LI Xue-hua, JIN Li-de, TAO Wei-hua, QIAN Xi-ying, ZHAO Jian-hua. Analysis of risk factors for epileptic seizure after combined revascularization in adult patients with moyamoya disease[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2022, 22(7): 586-591.

杨帅峰, 李雪华, 金立德, 陶维华, 钱希颖, 赵建华. 成人烟雾病联合血管重建术后癫痫发作特点及危险因素分析[J]. 中国现代神经疾病杂志, 2022, 22(7): 586-591.

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URL: https://journal11.magtechjournal.com/cjcnn/EN/10.3969/j.issn.1672-6731.2022.07.007

https://journal11.magtechjournal.com/cjcnn/EN/Y2022/V22/I7/586

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