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Predictors of seizures after lateral skull base tumor resection: A retrospective study.

Jinhong Wu, Wenxian Li

Objective: Lateral skull base tumor resection can lead to many complications, including seizures. The actual cause of such seizures is not well understood. We carried out this retrospective study to help identify predictors of post-lateral skull base tumor resection seizures. Methods: Twenty-eight American Society of Anesthesiologists (ASA) grade I-II adult patients, aged 18-62 years who underwent lateral skull base tumor resection were included in this retrospective study. Clinical data were obtained from electronic medical records. Data on of operation time, anesthesia time, end tidal CO2 and use of dexamethasone, mannitol and furosemide were obtained from electronic anesthesia records. MRI signal value of temporal lobe on MRI was determined from preoperative and postoperative MRI images take taking from on the lesion side and from the contralateral side. Data were analysed using the Mann-Whitney-Wilcoxon test or the Chi-square test. Results: Of the 28 subjects in this study, 4 had seizures after surgery, 2 generalized and 2 partial. These 4 subjects were put into a group called S+ and the remaining 24 subjects were put into a group called S-. Comparison of clinical data for members of the two groups showed no significant differences in basic clinical characteristics, aside from preoperative total protein levels, which were significantly lower in the S+ group compared to the S- group (66.50 ± 5.26 vs. 73.42 ± 5.34). Interestingly, operation time and anesthesia time were significantly shorter in the S+ group (3.34 ± 1.67 h and 3.77 ± 1.64 h, respectively) compared to the S- group (6.84 ± 2.60 h and 7.35 ± 2.64 h, respectively). In addition, postoperative MRI signal value on MRI was significantly higher in the S+ group compared to the Sgroup (509.50 ± 24.91 vs. 411.79 ± 72.70). Conclusion: Acute temporal lobe swelling may lead to seizures after lateral skull base surgery, especially after surgeries lasting less than 4 h.