Is Shunt Location a Risk Factor for the Development of De Novo Post-shunt Seizures?

Abstract

Background: While ventriculo-extracranial shunting procedures have been the standard treatment option for hydrocephalus for a long time, their long-term morbidity, including the development of post-shunt de novo seizures, should be taken into account. This study aimed to investigate the rate and risk factors of the occurrence of de novo post-shunt seizures in patients with hydrocephalus. Methods: In this retrospective longitudinal study, all patients with hydrocephalus who had ventriculo-peritoneal shunt insertion from 2014 to 2017 at Namazi Hospital, (Shiraz, Iran) were studied. Phone calls were made to all patients to obtain their postoperative seizure outcome and other data (e.g., sex, age at surgery, shunt insertion location, history of seizures before surgery, history of seizures after surgery, any other type of brain surgery, and the etiology of their hydrocephalus). The Pearson Chi Square was used for the analysis of binary variable (e.g., sex) differences, and the t test for the analysis of differences in the means of numerical variables (e.g., age). Bonferroni correction tests were also utilized. P values less than 0.05 were considered significant.Results: A total of 114 patients were included in the study. Overall, 68 (60%) patients had a frontal location of shunt insertion and 46 (40%) had a parietal site. Twenty-four (21%) patients reported experiencing de novo post-shunt seizures, 15 of which had a frontal location and nine a parietal location for shunt insertion (P=0.824). Conclusion: De novo post-shunt seizures are common occurrences. However, shunt location is not a significant risk factor for the development of de novo post-shunt seizures.

Keywords

• brain
• epilepsy
• seizures
• neurosurgery