Analysis of the risk factors of post-operative seizure in pediatric patients with hydrocephalus undergoing endoscopic third ventriculostomy

Abstract

Methods: Data of pediatric patients with hydrocephalus who were treated with ETV from October 1, 2015, to November 31, 2021, were retrospectively analyzed. Basic demographic characteristics, etiology of hydrocephalus, surgical details, and laboratory measurements were collected. An early postoperative seizure was de ned as the occurrence of at least one clinical seizure within 24 h of ETV.Results: A total of 50 participants were included in the study, of whom 5 (10.00%) cases were in postoperative epilepsy group and 45 (90.00%) cases were in non-epilepsy group. Epilepsy patients were younger than those without epilepsy, while no statistically signi cant difference was found (P = 0.0836). In the age subgroup, children with epilepsy were younger than 2 years old. All patients with epilepsy received Ringer's solution intraoperatively. The mean postoperative serum calcium and potassium concentrations were signi cantly lower in patients with epilepsy than in those without epilepsy (P calcium =0.0429; P potassium = 0.0250). Moreover, a faster decrease of serum potassium and calcium levels was found in children with epilepsy compared with those without epilepsy after ETV. Conclusion:The decrease of serum calcium and potassium levels, younger age, and using Ringer's solution as irrigation uid were risk factors for epilepsy after ETV.

The impact of serum magnesium and calcium on the risk of epilepsy: A mendelian randomization study

“…Recently, animal research showed a certain relationship between magnesium homeostasis and acute or chronic seizures 13 . Likewise, lower serum calcium concentrations was reported to be associated with a higher risk of epilepsy 9,10,14 . As we know, hypomagnesaemia can cause serum calcium levels to decline by affecting the synthesis or secretion of parathyroid hormone.…”

“… 13 Likewise, lower serum calcium concentrations was reported to be associated with a higher risk of epilepsy. 9 , 10 , 14 As we know, hypomagnesaemia can cause serum calcium levels to decline by affecting the synthesis or secretion of parathyroid hormone. In addition, low levels of serum calcium, together with low magnesium levels, can lead to membrane hyperexcitability in neurons, which has been found to be strongly related to seizures in both children and adults.…”