Effect of Epanutin in Controlling fits in Paediatric Patients with Posterior Fossa Ependymoma

Aim: The purpose of this study is to discuss efficacy of epanutin in controlling fits in patients with posterios fossa ependymoma in paediatric patients and the surgical removal of posterior fossa ependymoma tumour, focusing on the extent of the surgery and the resulting outcomes. Materials And Methods: From January 2022 to December 2023, a total of 10 children diagnosed with fourth ventricular ependymoma underwent surgery using the telovelar technique. An assessment was conducted to determine the extent of radicality, neurological result, comorbidities, and survival rates. A statistical analysis was conducted to assess the ameliorative impact of epanutin in controlling convulsions in patients with posterios fossa ependymoma in paediatric patients. Results: Complete excision of the tumor was successfully accomplished in 8 individuals, representing 80% of the total. Every patient necessitated the diversion of cerebrospinal fluid (CSF) by means of a ventriculoperitoneal shunt. One patient (10%) experienced cerebellar mutism, one patient (10%) experienced bulbar paralysis (lower cranial nerve palsy), and 3 patients (30%) exhibited tumor recurrence. Subtotal resection (p=0.020) and anaplastic ependymoma (p=0.038) were shown to be linked with a poor prognosis, as indicated by overall and progression-free survival rates. Moreover, twelve patients showed convulsions in postoperative period and epanutin was used in these patients and controlled fits in 75% of these patients. Conclusion: The telovelar technique offers a sufficient anatomical view of the fourth ventricle and enables early observation and safeguarding of its floor (brainstem). It promotes sufficient thoroughness and is linked to a reduced occurrence of cerebellar mutism and other issues related to the method. Removing the posterior arch of the atlas can enhance the working angle, especially towards the front section of the fourth ventricle. Epanutin is effective in controlling convulsions in patients with posterior fossa ependymoma.