7. Intraoperative seizures during intraoperative motor monitoring: A retrospective study

Aim of this retrospective study is to evaluate the appearance of intraoperative seizures during motor monitoring in brain surgery and to find correlation to stimulation and clinical features. A total of 37 consecutive patients were divided in 2 groups: a prophylaxis group and a therapy group. Patients in prophylaxis group didn’t present seizures in their clinical history and underwent to a brief period of antiepileptic treatment before and after surgery. Patients in therapy had a seizures and therapy in their clinical history before surgery. Intraoperative seizures were recorded in 5 patients, 1 patients belonged to the prophylaxis group and 4 patients belonged to the therapy group. In 2 patient seizures were related to cortical stimulation with train of four technic. Our results confirm the low incidence of seizures during intraoperative motor monitoring described in literature. Seizure related to stimulation are reported from 1.2% (Sala 2003) to 9.5% (Berger 1989) in relation to different stimulation technics, lesser than 5% with train of five technic. There are also a relevant variability in data from 20% to 50% (Sartorius 1997, Yingling 1999, Bello 2014). Further multicentric studies need in order to obtain static significativity.