[Complications during epilepsy surgery. Experience after 102 interventions between 1997 and 2001].
OBJECTIVE
To describe perioperative complications in different approaches to surgery for epilepsy.


METHODS
All patients undergoing surgery related to epilepsy between January 1997 and December 2001 were studied. We gathered information on patient characteristics, diagnosis, anticonvulsant treatment, surgical procedure, type of anesthesia and perioperative complications.


RESULTS
Ninety-eighty patients underwent 90 procedures under general anesthesia and 12 procedures with local anesthesia and sedation. Surgery was for anteromedial temporal resection in 74 patients, electrode implantation through the foramen ovale in 10 patients, extratemporal excisions in 7 patients, callosotomy in 3 patients, functional hemispherectomy in 3 patients, implantation of electrode grids in 2 patients, and craniotomy with an awake patient in 3 cases. Complications related to the surgical procedure were intraoperative bradycardia (5 cases), dural tension at the start of surgery (3), bleeding (2) and seizure (1). Complications related to anesthesia were bronchospasm (2 cases), histamine-releasing reaction upon administration of the muscle relaxant (1), and difficult intubation (1). During recovery we saw 1 case of postoperative aphasia, 1 of polyuria, 1 of pulmonary condensation, and 1 of factor VII deficit requiring plasma transfusion.


CONCLUSIONS
The rate of perioperative complications in surgery for drug-resistant epilepsy is low, the most common complication being self-limiting bradycardia related to surgical maneuvers.
Sánchez-Etayo
G
G
Servicio de Anestesiología y Reanimación, Servicio de Neurocirugía, Hospital Clínic, Barcelona.
Valero
R
R
Carrero
E
E
Salvador
L
L
Rumià
J
J
Fàbregas
N
N
D000328:Adult; D000758:Anesthesia / Q000009:adverse effects; D000777:Anesthetics / Q000009:adverse effects; D001919:Bradycardia / Q000453:epidemiology / Q000209:etiology; D003337:Corpus Callosum / Q000601:surgery; D004567:Electrodes, Implanted; D004827:Epilepsy / Q000601:surgery*; D005260:Female; D038421:Hemispherectomy; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents / Q000009:adverse effects; D019635:Neurosurgical Procedures; D012189:Retrospective Studies; D013702:Temporal Lobe / Q000601:surgery
D000777:Anesthetics; D003473:Neuromuscular Nondepolarizing Agents