AANS Online Scientific Sessions: Trauma-Elucidating Incidence and Outcomes of Perioperative Status Epilepticus after Neurosurgical Procedures

Video Transcription

Video Summary

The speaker, Jonathan Parker, discusses the incidence and outcome of perioperative status epilepticus after intracranial neurosurgery in a video presentation. Parker presents a case example of a patient who experienced status epilepticus after surgery and suffered multiple complications, eventually resulting in death. He highlights the rarity of this complication but emphasizes its significance due to its association with morbidity, mortality, increased healthcare costs, and long-term quality of life. The study used the IBM Watson Health MarketScan database to analyze nationwide data of patients who underwent intracranial neurosurgical procedures. Risk factors for post-neurosurgical status epilepticus are poorly understood, and the study aims to identify modifiable risk factors. The incidence of immediate and delayed status epilepticus is low but has increased over time, potentially due to improved recognition and coding. Trauma, hematoma, and elevated intracranial pressure cases have the highest risk of immediate status epilepticus, while infection and CSF diversion procedures have the highest risk of delayed status epilepticus. Patients undergoing meningioma resection have the highest risk of immediate post-neurosurgical status epilepticus, while those with primary brain tumor resections have the highest risk of delayed status epilepticus. Immediate post-neurosurgical status epilepticus is associated with longer ICU and hospital stays, and the use of continuous EEG has increased over time. The study acknowledges limitations, such as the accuracy of ICD-9 codes in identifying status epilepticus events and the inability to differentiate convulsive and non-convulsive status epilepticus.

Asset Subtitle

Jonathon J. Parker MD, PhD

Keywords

perioperative status epilepticus

intracranial neurosurgery

complications

morbidity

mortality