Postoperative incidence of seizure and ischemic events in patients with epileptic type moyamoya disease: a meta-analysis of single rate

Abstract BackgroundSurgery is a conventional mature treatment for moyamoya disease (MMD). However, whether surgery is also an effective therapy for epileptic type MMD has seldom been investigated systematically. The study aims to summarize the pooled postoperative incidence of seizure and ischemic events in patients with epileptic type moyamoya disease.MethodThe study was a systematic review and critical appraisal with a meta-analysis of cohort studies, both prospective and retrospective. Studies were identified by a computerized search of Pubmed, EMBASE, Web of Science, Wanfang, and CNKI databases. In a literature search, a total of 8 cohort studies were identified. The I2statistic was used to quantify heterogeneity. A fixed-effect model was used to synthesize the results. The linear regression test of funnel plot asymmetry was used to estimate the potential publication bias.ResultsThe pooled estimated postoperative incidence of seizure in patients with epileptic type moyamoya disease was 21.52%. The pooled estimated postoperative incidence of ischemic events in patients with epileptic type moyamoya disease was7.42%. Low substantial heterogeneity and potential publication bias were present.ConclusionEvidence from this study suggests that the postoperative incidence of seizure and ischemic events is relatively low. Surgery is an effective and secure therapy for patients with epileptic type moyamoya disease.