The Clinical Study Of Ambulatory Electroencephalogram In The Reduction Of Prophylactic Antiepileptic Drugs After Craniotomy

Objective : To retrospectively analyze the characteristics of ambulatory electroencephalogram(AEEG)in postcraniotomy patients,with epileptic seizures and without seizures after Reduction of preventive antiepileptic drug,We qualitatively and quantitatively analyze the relationship between AEEG waveforms and seizures,to explore the guideline value of AEEG for the reduction of prophylactic antiepileptic drugs.Methods : Selecting 166 patients(seizure group)with epileptic seizures after discontinuation of prophylactic antiepileptic drugs from 2010 to 2017 in the Department of Neurosurgery of our hospital.During the same period,166 patients without a seizure(non-epileptic seizure group)were selected,which have the similar proportions in age,gender,etiology,location with seizure group.The follow-up time was 1 to 8 years.Refering to the classification methods of Hughes J R,we divided them into several types: R type(rare),R-M type(rare-moderate),M type(moderate),M-Ltype(moderate-large),L type(large).;S type(scattered),F type(focal),P type(paroxysmal);NS type(non-sharp spike),RS type(rare sharp spike),MS type(moderate sharp spike),LS type(large sharp spike).The differences of AEEG waveforms between the two groups were compared.The seizure group was divided into a controlled group and an non-controlled group according to whether the epilepsy be controlled after taking the drugs again.The difference of the number of spike-wave between the two groups was compared.Results:(1)Significant differences present in AEEG type composition ratio between patients in the seizure group and non-epilepsy seizure group.In the seizure group,the main type is M-type,P-type and MS-type.In the non-epilepsy seizure group,the main type is R-type,S-type and RS-type.There were 91 patients(91/166,54.8%)with M,M-L and L type in the seizure group,107 patients(107/166,64.4%)with P type,116 patients with spikes of MS and LS type(116/ 166,69.8%),which was significantly higher than the non-epilepsy seizure group(14.5%,34.3%,22.9%).The high-risk waveforms of seizures after discontinuation of prophylactic antiepileptic drugs are M,M-L,L,P type and MS,LS(OR>1).(2)After taking the drug again,the number of patients in the control group gradually decreased from RS-type to LS-type,and the numbers in the uncontrolled group gradually increased.Conclusion : The high-risk waveforms for postcraniotomy seizures after discontinuation of anti-epileptic drugs are M,M-L,L,P type and MS,LS type.AEEG has a certain role in the prevention and treatment of antiepileptic drugs in patients undergoing neurosurgical craniotomy.