# A New Predictor Score for Postoperative Seizures in Brain Tumor Patients Without a Seizure History (BRAINNN Score)

## TL;DR

This study creates a new scoring system to predict postoperative seizures in brain tumor patients without a seizure history, aiming to improve AED use and patient outcomes.

## Contribution

The BRAINNN Score is a novel predictive tool for postoperative seizure risk in brain tumor patients without prior seizures.

## Key findings

- Over 20% of patients experienced postoperative seizures.
- Five significant predictors were identified, including tumor location and age.
- The BRAINNN Score improves seizure risk assessment and control.

## Abstract

Objective: To identify risk factors for postoperative seizures in patients with brain tumors without preoperative seizures and develop a predictive scoring system to guide antiepileptic drug (AED) prophylaxis.

Material and methods: A retrospective analysis was conducted on patients with intra-axial brain tumors and no history of preoperative seizures or AED use. Logistic regression identified significant predictors of postoperative seizures, and a scoring system was created using receiver operating characteristic (ROC) analysis. Data were drawn from a neuro-oncology database that had been active since 1970.

Results: A total of 446 patients were included from 16,918 records, with a mean age of 45.1 years (67.8% male, 345 with gliomas). Over 20% experienced postoperative seizures. Logistic regression identified five significant predictors, including tumor location, patient age, extent of resection, and neoplastic edema. A scoring system was developed to improve seizure risk assessment and seizure control. The BRAINNN Score (Brain tumor-associated Risk Assessment Index developed at the National Institute of Neurology and Neurosurgery, INNN) is a newly designed predictive tool to estimate the risk of postoperative seizures in brain tumor patients without a prior history of seizures.

Conclusions: This study proposes a personalized approach to AED prophylaxis using a novel, objective scoring system based on clinically relevant factors. This framework has the potential to optimize perioperative care and improve outcomes for patients with brain tumors.