Seizures in intracranial endoscopy in children

In the past years, neuroendoscopic procedures have been applied with a constantly broadening of indications. One major indication for neuroendoscopic surgery is the physiological restoration of cerebrospinal fluid circulation in obstructive hydrocephalus. Possible complications include contusion of fornix, hypothalamus or pituitary gland or lesion of cranial nerves. Only rare data exist on the onset of epileptic seizures after neuroendoscopic procedures. Between April 1993 and October 2007, 134 neuroendoscopic procedures were performed in 126 children with different intracranial pathologies. The postoperative clinical course and the outcome of the patients was analyzed retrospectively with special regard to pre- and postoperative epileptic seizures. Endoscopic surgery was performed for the treatment of aqueductal stenosis in 23 patients (18.3%), intracranial tumor formation in 48 patients (38.1%), intracranial cysts in 24 patients (19%), brain malformation in 20 patients (15.9%), intracerebral hemorrhage in six patients (4%) and isolated ventricle in five patients (4.8%). Most children presented with mild to severe signs of increased intracranial pressure. Postoperatively, transient complications occurred in 17 cases (12.7%) and permanent complica- tions occurred in two patients (1.5%). In seven children, seizures have been observed preoperatively. The seizures have been observed in different pathologic entities. Additionally, a convulsive disorder did not occur postoperatively as a complication. A new onset of seizures after neuroendoscopic surgery has not been found. The present data do not speak for an increased risk of developing a convulsive disorder in children after neuroendoscopic surgery.