Surgery

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Browsing Surgery by Author "Abdulahi, Mohammednur"

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    Post-operative Seizure Status Among Patients Operated for Brain Tumor with Seizure- Multicenter Retrospective Cross-sectional Study
    (Addis Abeba University, 2020-12) Abdulahi, Mohammednur; Zewdie, Kibruyisfaw (MD, Assistant professor in Neurosurgery)
    Background: Seizure is one of common presentations of brain tumor. Surgical resection is useful in controlling seizures and in eradicating the symptoms associated with compression. Objective: The aim of this research was to examine postoperative seizure status and factors significantly associated with postoperative seizure control following brain tumor surgery in patients with brain tumor and seizure. Methods: Multicenter retrospective cross-sectional study was conducted among 97 patients with brain tumor and seizure who had undergone initial surgery at three selected teaching hospitals in central Ethiopia from January 1, 2015 to December 31, 2019. Assessment of postsurgical seizure status were described using Engel’s classification of seizure: completely seizure free (Engel class I), and not seizure free (Engel classes II, III, IV). Demographic, seizure history, radiographic characteristics, histopathologic diagnosis, treatment, preoperative and postoperative antiepileptic drug use data were collected and analyzed for statistical association with postoperative seizure control using univariate and multivariate logistic regression analyses. P- Values of less than 0.05 and confidence level of 95% were considered to indicate statistical significance and strength of association respectively. Results: Ninety seven patients (60 females, 37 males) were included, with a mean age of 41.7 years and a median seizure duration of 8 months. There were generalized tonic-clonic seizures in 52 patients (53.6%).The histopathology confirmed meningioma in 71.1% (n = 69) of patients, low grade glioma in 12.4% (n = 12), and high grade glioma in 11.3% (n = 11) of patients. Gross total resection was achieved in 80.4% (n = 78) of patients and subtotal resection in 19.6% (n = 19) of patients. During a median follow-up of 6 months (range 3 months to 3 years), 66% of patients were seizure free (Engel’s Class I). Seizure freedom was predicted by gross total resection (adjusted OR 6.24, 95% CI: 1.79-21.71, P=0.004) and seizure duration ≤ 1 year before surgery (adjusted OR 3.60, 95% CI: 1.20-10.82, P=0.022) on multivariate analysis. Occurrence of postoperative weakness after surgery (adjusted OR 16.23, 95% CI: 2.57-103.09, P=0.003) and uncontrolled preoperative seizure (adjusted OR 4.69, 95% CI: 1.49-14.75, P=0.008) were found to be significant independent predictors associated with uncontrolled postoperative seizure status. Conclusions: Sixty six percent of brain tumor patients in this study were seizure-free following surgery. Specific variables that were strongly associated with seizure-free outcome included gross total resection and seizure duration ≤ 1 year prior to surgery. These findings suggest that strict preoperative seizure control, early surgical intervention, and complete tumor resection increases the chance of postoperative seizure control.