Postoperative incidence of seizure and cerebral infarction in pediatric patients with epileptic type moyamoya disease: a meta-analysis of single rate

Jingjing Liu,Rong Wang,Xun Ye,Qinlan Xu,Xianzeng Liu,Hongchuan Niu

doi:10.1186/s41016-020-00224-y

Abstract

BackgroundSurgery is a conventional mature treatment for moyamoya disease (MMD). However, whether surgery is also an effective therapy for epileptic type MMD has seldom been investigated systematically. The study aims to summarize the pooled postoperative incidence of seizure and cerebral infarction in pediatric patients with epileptic type moyamoya disease.MethodThe study was a systematic review and critical appraisal with a meta-analysis of cohort studies, both prospective and retrospective. Studies were identified by a computerized search of PubMed, Embase, Web of Science, Wanfang, and CNKI databases. In a literature search, a total of 7 cohort studies were identified. The I2statistic was used to quantify heterogeneity. A fixed-effect model was used to synthesize the results. The linear regression test of funnel plot asymmetry was used to estimate the potential publication bias.ResultsThe pooled estimated postoperative incidence of seizure in pediatric patients with epileptic type moyamoya disease was 23.44%. The pooled estimated postoperative incidence of cerebral infarction in pediatric patients with epileptic type moyamoya disease was 9.12%. Low substantial heterogeneity and potential publication bias were present.ConclusionsEvidence from this study suggests that the postoperative incidence of seizure and cerebral infarction is relatively low. Surgery is an effective and secure therapy for pediatric patients with epileptic type moyamoya disease.

Highlights

Surgery is a conventional mature treatment for moyamoya disease (MMD)
Evidence from this study suggests that the postoperative incidence of seizure and cerebral infarction is relatively low
The summarized pooled postoperative incidence rate of seizure in pediatric patients with epileptic type MMD in the seven studies using the fixed-effects models was 23.44% with low heterogeneity (Tau2 = 0, I2 = 0% (95%CI 0–67.2%), P = 0.5) (Fig. 2 a)

Summary

Introduction

Surgery is a conventional mature treatment for moyamoya disease (MMD). whether surgery is an effective therapy for epileptic type MMD has seldom been investigated systematically. The study aims to summarize the pooled postoperative incidence of seizure and cerebral infarction in pediatric patients with epileptic type moyamoya disease. The name “moyamoya” means “puff of smoke” in Japanese and describes the appearance of the formation of smoke-like abnormal blood vessels in the base of the skull in cerebral angiography. It frequently occurs in the East Asian population, may cause ischemic or hemorrhage stroke, epilepsy, headache, or transient ischemic attack (TIA) [2]. Some of the epileptic type patients suffer seizures as the first symptom, and others may be secondary to ischemic stroke [6]. About 20–30% of MMD patients present with seizures [9], but only 3– 4% epileptic type MMD without vascular events [10, 11]

Methods

Results

Discussion

Conclusion