PO30INTRA-OPERATIVE SEIZURES IN AWAKE CRANIOTOMY

Abstract

INTRODUCTION: Intra-operative seizure is a recognised complication of awake craniotomy (AC) to resect/debulk intracerebral tumour. If not adequately controlled, it may lead to abandonment of the procedure. Here we reviewed the incidence of intra-operative seizure in all AC patients at a regional neurosurgical centre, and examined its association with tumour type and pre-operative use of anti-epileptic drugs (AEDs). METHOD: Review of patients' medical notes. RESULTS: In total, 42 AC were performed on 38 patients. 33.3% (14/42) AC were complicated by intra-operative seizures, resulting in 3 procedures being abandoned. Out of seven patients with low-grade glioma in this series, 71.4% (5/7) had intra-operative seizures. The incidence of intra-operative seizure was 40.0% for high-grade oligodendroglioma, 33.3% for anaplastic astrocytoma and 20.0% for glioblastoma multiforme. Out of all 38 patients, 33 had seizures as a presenting symptom. Of these, 36.4% (12/33) developed intra-operative seizures, while 20.0% (1/5) of those who did not present with a seizure developed intra-operative seizures. 30.6% (11/36) patients who received pre-operative AED developed seizures intra-operatively, compared to 100% (2/2) of those without pre-operative AED. CONCLUSION: 33.3% of patients who underwent AC developed intra-operative seizures. Patients with low-grade glioma were most at risk in our limited series. Pre-operative use of AEDs appeared to reduce the risk of intra-operative seizures. Larger studies are warranted.