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

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.

Keywords

• moyamoya disease
• cerebral revascularization
• epilepsy
• postoperative complications
• risk factors
• logistic models