Эпилепсия и пароксизмальные состояния (Jan 2022)

Assessing efficacy of endoscopic ventriculocisternostomy using a semi-rigid needle endoscope in сhildren with hydrocephalus and concomitant drug-resistant epilepsy: results of CT brain perfusion and time-frequency EEG analysis

  • A. A. Sufianov,
  • G. Z. Sufianova,
  • A. G. Shapkin,
  • I. S. Shelyagin,
  • A. A. H. Al Zakhrani,
  • R. R. Rustamov,
  • S. Zh. Stefanov,
  • A. M. Khayretdinov,
  • R. A. Sufianov,
  • K. Simfukwe

DOI
https://doi.org/10.17749/2077-8333/epi.par.con.2021.105
Journal volume & issue
Vol. 13, no. 4
pp. 349 – 358

Abstract

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Background. The probability of seizures after endoscopic surgical treatment of hydrocephalus may comprise up to 9.5%, therefore accounting for a need to find solutions for alleviating the surgical trauma to the brain. One option to this problem might be based on using “seamless” neurosurgery, particularly endoscopes with a minimal outer sheath diameter (needle endoscopes, shunt endoscopes).Objective: to evaluate major outcomes of surgically treated epilepsy, cerebral haemodynamics and electroencephalogram (EEG) in children with hydrocephalus and concomitant drug-resistant epilepsy before and after endoscopic ventriculocysternostomy of the third ventricular floor by using a semi-rigid needle endoscope.Material and methods. In the early and remote postoperative periods, no epileptic seizures were observed in 57.1% of subjects (Engel Class I). Mean seizure frequency decreased from 12.9±6.1 to 0.82±0.31 per month (p<0.01). A significant decline in slow-wave amplitude and the paroxysmal index from 19.1±2.5% to 6.9±1.7% (p<0.01) were observed, as well as improvement of cerebral hemodynamics in the form of increased mean cerebral blood flow by 29.1±4.3% (p<0.01), mean circulating blood volume by 22.4±5.27% (p<0.05) and decreased mean transit time by 12.8±2.5% (p<0.05).Results. In the early and remote postoperative periods, no epileptic seizures were observed in 57.1% of subjects (Engel Class I). Mean seizure frequency decreased from 12.9±6.1 to 0.82±0.31 per month (p<0.01). A significant decline in slow-wave amplitude and the paroxysmal index from 19.1±2.5% to 6.9±1.7% (p><0.01) were observed, as well as improvement of cerebral hemodynamics in the form of increased mean cerebral blood flow by 29.1±4.3% (p><0.01), mean circulating blood volume by ><0.01). A significant decline in slow-wave amplitude and the paroxysmal index from 19.1±2.5% to 6.9±1.7% (p<0.01), mean circulating blood volume by 22.4±5.27% (p<0.05) and decreased mean transit time by 12.8±2.5% (p><0.05).

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