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Epilepsy and paroxysmal conditions

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Assessing efficacy of endoscopic ventriculocisternostomy using a semi-rigid needle endoscope in сhildren with hydrocephalus and concomitant drug-resistant epilepsy: results of CT brain perfusion and time-frequency EEG analysis

https://doi.org/10.17749/2077-8333/epi.par.con.2021.105

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Abstract

Background. The probability of seizures after endoscopic surgical treatment of hydrocephalus may comprise up to 9.5%, therefore accounting for a need to find solutions for alleviating the surgical trauma to the brain. One option to this problem might be based on using “seamless” neurosurgery, particularly endoscopes with a minimal outer sheath diameter (needle endoscopes, shunt endoscopes).

Objective: to evaluate major outcomes of surgically treated epilepsy, cerebral haemodynamics and electroencephalogram (EEG) in children with hydrocephalus and concomitant drug-resistant epilepsy before and after endoscopic ventriculocysternostomy of the third ventricular floor by using a semi-rigid needle endoscope.

Material and methods. In the early and remote postoperative periods, no epileptic seizures were observed in 57.1% of subjects (Engel Class I). Mean seizure frequency decreased from 12.9±6.1 to 0.82±0.31 per month (p<0.01). A significant decline in slow-wave amplitude and the paroxysmal index from 19.1±2.5% to 6.9±1.7% (p<0.01) were observed, as well as improvement of cerebral hemodynamics in the form of increased mean cerebral blood flow by 29.1±4.3% (p<0.01), mean circulating blood volume by 22.4±5.27% (p<0.05) and decreased mean transit time by 12.8±2.5% (p<0.05).

Results. In the early and remote postoperative periods, no epileptic seizures were observed in 57.1% of subjects (Engel Class I). Mean seizure frequency decreased from 12.9±6.1 to 0.82±0.31 per month (p<0.01). A significant decline in slow-wave amplitude and the paroxysmal index from 19.1±2.5% to 6.9±1.7% (p><0.01) were observed, as well as improvement of cerebral hemodynamics in the form of increased mean cerebral blood flow by 29.1±4.3% (p><0.01), mean circulating blood volume by ><0.01). A significant decline in slow-wave amplitude and the paroxysmal index from 19.1±2.5% to 6.9±1.7% (p<0.01), mean circulating blood volume by 22.4±5.27% (p<0.05) and decreased mean transit time by 12.8±2.5% (p><0.05).

About the Authors

A. A. Sufianov
Sechenov University; Federal Center of Neurosurgery
Russian Federation

Albert А. Sufianov – Dr. Med. Sc., Professor, Chief of Chair of Neurosurgery, Sechenov University; Chief Physician, Federal Center of Neurosurgery

Scopus Author ID: 6603558501; RSCI SPIN-code: 1722-0448

8/2 Trubetskaya Str., Moscow 119991

5 4th km of Chervishevskiy Tract, Tyumen 625032



G. Z. Sufianova
Federal Center of Neurosurgery; Tyumen State Medical University
Russian Federation

Galina Z. Sufianova – Dr. Med. Sc., Professor, Clinical Pharmacologist, Federal Center of Neurosurgery; Chief of Chair of Pharmacology, Tyumen State Medical University

WoS ResearcherID: C-4741-2017; RSCI SPIN-code: 3099-2780

5 4th km of Chervishevskiy Tract, Tyumen 625032

54 Odesskaya Str., Tyumen 625023



A. G. Shapkin
Federal Center of Neurosurgery; Tyumen State Medical University
Russian Federation

Andrey G. Shapkin – MD, PhD, Neurosurgeon, Federal Center of Neurosurgery, Associate Professor, Chair of Pharmacology, Tyumen State Medical University

RSCI SPIN-code: 8656-9879

5 4th km of Chervishevskiy Tract, Tyumen 625032

54 Odesskaya Str., Tyumen 625023



I. S. Shelyagin
Federal Center of Neurosurgery
Russian Federation

Ivan S. Shelyagin – Neurosurgeon, Federal Center of Neurosurgery

RSCI SPIN-code: 4188-2029

5 4th km of Chervishevskiy Tract, Tyumen 625032



A. A. H. Al Zakhrani
Sechenov University
Russian Federation

Abdurakhman A. Al Zakhrani – Postgraduate, Chair of Neurosurgery

8/2 Trubetskaya Str., Moscow 119991



R. R. Rustamov
Federal Center of Neurosurgery
Russian Federation

Rakhmonzhon R. Rustamov – Neurosurgeon, Federal Center of Neurosurgery

RSCI SPIN-code: 7311-9781

5 4th km of Chervishevskiy Tract, Tyumen 625032



S. Zh. Stefanov
Federal Center of Neurosurgery
Russian Federation

Stefan Zh. Stefanov – Deputy Chief Physician, Neurosurgeon

5 4th km of Chervishevskiy Tract, Tyumen 625032



A. M. Khayretdinov
Federal Center of Neurosurgery
Russian Federation

Aydar M. Khayretdinov – Functional Diagnostician

5 4th km of Chervishevskiy Tract, Tyumen 625032



R. A. Sufianov
Sechenov University
Russian Federation

Rinat A. Sufianov – Assistant Professor, Chair of Neurosurgery

Scopus Author ID: 56001416700; RSCI SPIN-code: 1204-2994

8/2 Trubetskaya Str., Moscow 119991



K. Simfukwe
Sechenov University
Russian Federation

Keith Simfukwe – Postgraduate, Chair of Neurosurgery

8/2 Trubetskaya Str., Moscow 119991



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Review

For citations:


Sufianov A.A., Sufianova G.Z., Shapkin A.G., Shelyagin I.S., Al Zakhrani A.A., Rustamov R.R., Stefanov S.Z., Khayretdinov A.M., Sufianov R.A., Simfukwe K. Assessing efficacy of endoscopic ventriculocisternostomy using a semi-rigid needle endoscope in сhildren with hydrocephalus and concomitant drug-resistant epilepsy: results of CT brain perfusion and time-frequency EEG analysis. Epilepsy and paroxysmal conditions. 2021;13(4):349-358. (In Russ.) https://doi.org/10.17749/2077-8333/epi.par.con.2021.105

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ISSN 2077-8333 (Print)
ISSN 2311-4088 (Online)