OBJECTIVES Awake Craniotomy (AC) is a very well described technique that is performed to make an adequate tumor resection preserving the functionality of the patient. Intraoperative Seizures (IS) are reported as a failure of such procedure. We analyze the incidence and risk factor during AC. METHODS We made a review of the database of the National Institute of Neurology and Neurosurgery between January 2017 and May 2019 for intrinsic tumors located in eloquent areas of the brain. An analysis of ISconcerning the clinical history, clinical presentation, imaging techniques, histological findings and surgical technique was made. The factors associated with Mapping Failure (MF) were also evaluated. RESULTS 45 patients were included of whom 7 patients (15.6%) developed IS after cortical-subcortical stimulation, 5 presented partial motor seizures (11.1%) and 2 experimented generalized secondary seizures (4.5%). Of the patients that had a MF, one patient (14%) was due to generalized tonic-clonic seizures which couldn't be managed by cold saline irrigation and administration of anti-seizures drugs and was then converted to a general anesthetic technique. We observed that the patients that had a bigger tumoral volume (112.2 cm3 85.3, P = 0,07) had a bigger positive relation in presenting IS, having a peak sensibility and specificity above 70 cc (ROC). CONCLUSIONS In our analysis IS are more common in patients with high presurgical tumor volume. Even though the majority of the patients that presented IS didn't develop MF, it is important to acknowledge that the multidisciplinary group in the operating room must be prepared to detect these complications, treat them promptly and avoid MF.

中文翻译：

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雄辩区双极脑映射术中癫痫的分析

目的 清醒开颅术 (AC) 是一种被很好描述的技术，用于进行充分的肿瘤切除，保留患者的功能。术中癫痫发作 (IS) 被报告为此类手术的失败。我们分析了 AC 期间的发生率和危险因素。方法 我们对 2017 年 1 月至 2019 年 5 月期间美国国立神经病学和神经外科研究所的数据库进行了审查，其中包含位于大脑雄辩区的固有肿瘤。对IS的临床病史、临床表现、影像学技术、组织学发现和手术技术进行了分析。还评估了与映射失败 (MF) 相关的因素。结果 包括 45 名患者，其中 7 名患者（15.6%）在皮层 - 皮层下刺激后出现 IS，5 名患者出现部分运动性癫痫发作（11. 1%) 和 2 例全身性继发性癫痫发作 (4.5%)。在有 MF 的患者中，1 名患者 (14%) 是由于全身强直阵挛性癫痫发作，无法通过冷盐水冲洗和服用抗癫痫药物治疗，然后转为全身麻醉技术。我们观察到肿瘤体积较大的患者 (112.2 cm3 85.3, P = 0,07) 在呈现 IS 方面具有更大的正相关性，峰值敏感性和特异性高于 70 cc (ROC)。结论 在我们的分析中，IS 在术前肿瘤体积较大的患者中更为常见。尽管大多数出现 IS 的患者没有发展为 MF，但重要的是要承认手术室中的多学科小组必须准备好发现这些并发症、及时治疗并避免 MF。