Epilepsy and adverse quality of life in surgically resected meningioma

Tanti, Matthew; Marson, Anthony G; Jenkinson, Michael D.

doi:10.1111/ane.12711

Cited by 32 publications

(25 citation statements)

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“…location in the dominant hemisphere or frontal lobes, tumors causing seizures and requiring anti-epileptic medications, incomplete resection, or higher histological grade. 4,[13][14][15][16][17][18] While these studies are valuable for prognostication, risk assessment, patient counseling, and treatment choice, they do not necessarily provide options for the vast majority of patients to improve their HRQoL after treatment of a meningioma. Supplementary Table 1 shows a summary of studies of HRQoL in meningioma patients, which outlines the deficiencies in the literature, including but not limited to small patient cohorts, variability in use of instruments, and population addressed.…”

Section: Neuro-oncologymentioning

confidence: 99%

Life after surgical resection of a meningioma: a prospective cross-sectional study evaluating health-related quality of life

Nassiri

Price

et al. 2019

Neuro-Oncology

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Background. Few studies have evaluated the health-related quality of life (HRQoL) of patients with meningiomas. Here, we report the largest prospective, longitudinal cross-sectional cohort study of HRQoL in meningiomas to date, in order to identify possible actionable determinants of global HRQoL. Methods. Adults who had undergone resection of a grade I intracranial meningioma and were in routine followup at a single large tertiary center underwent HRQoL assessment using the QLQ-C30 questionnaire administered opportunistically at follow-up visits. Averaged transformed QLQ-C30 scores at 12-month intervals were compared with scores from a normative reference population, with reference to known minimal clinically meaningful difference (CMD) in scores. To evaluate for possible determinants of changes in global HRQoL, global HRQoL scores were correlated (Spearman's Rho) with subdomain and symptom scores and with interval time from surgical resection. Results. A total of 291 postoperative patients with histologically confirmed and surgically treated grade I meningiomas consented to participation and a total of 455 questionnaires were included for analysis. Patients with meningiomas reported reduced global HRQoL at nearly every 12-month interval with clinically and statistically significant impairments at 12, 48, 108, and 120 months postoperative compared with the normative population (P < 0.05). Meningioma patients at the 12-month interval also reported a reduction of each subdomain of HRQoL assessment (P < 0.05); however, a CMD was only seen in cognitive functioning. Physical, emotional, cognitive, and social subdomains, as well as fatigue and sleep/insomnia, were significantly associated with global HRQoL at the first 12-month interval. Overall, there was no significant correlation between time from surgery and global HRQoL or the subdomain functional or symptom sections of the QLQ-C30. i33 Nassiri et al. Quality of life in meningioma patients Neuro-OncologyConclusions. Meningioma patients report considerable limitations in HRQoL for more than 120 months after surgery, particularly in cognitive, emotional, and social function, as well as suffering significant fatigue and sleep impairment compared with a normative reference population. The majority of these reported functional impairments and symptoms are strongly associated with global HRQoL and thus can be considered determinants of global HRQoL that if treated, have the potential to improve HRQoL for our meningioma patients. This hypothesis requires future study of targeted interventions to determine their efficacy. Keywords cognition | fatigue | health-related quality of life | insomnia | meningioma | surgeryWith advances in surgical techniques and adjuncts, and increasing adjuvant therapy options, there have been dramatic improvements in the care of brain tumor patients over the past two decades. Consequently, with extended survival and reduction of gross neurological morbidity, measures of treatment success have appropriately shifted to more patient-centered met...

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Section: Neuro-oncologymentioning

confidence: 99%

Life after surgical resection of a meningioma: a prospective cross-sectional study evaluating health-related quality of life

Nassiri

Price

et al. 2019

Neuro-Oncology

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“…Antiepileptic drugs (AEDs) are indicated for the treatment of brain tumour-related seizures, however, there still remains no consensus on whether prophylactic AEDs should be prescribed in seizure-naïve patients to prevent the development of postoperative seizures [ 4 ]. Epilepsy in meningioma patients is a major cause of morbidity and mortality [ 5 , 6 ], but the rate at which new seizures develop in patients undergoing meningioma surgery varies, and the efficacy of AEDs in reducing post-operative seizure rates remains questionable [ 7 , 8 ]. Furthermore, drug-related side effects, which can impair quality of life (QoL) and neurocognitive function (NCF), occur in up to half of patients [ 5 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Epilepsy in meningioma patients is a major cause of morbidity and mortality [ 5 , 6 ], but the rate at which new seizures develop in patients undergoing meningioma surgery varies, and the efficacy of AEDs in reducing post-operative seizure rates remains questionable [ 7 , 8 ]. Furthermore, drug-related side effects, which can impair quality of life (QoL) and neurocognitive function (NCF), occur in up to half of patients [ 5 , 9 , 10 ]. Therefore, appropriate selection of patients at risk of developing epilepsy in the peri-operative period and who might benefit from AED treatment for meningioma resection is important.…”

Section: Introductionmentioning

confidence: 99%

Postoperative seizures in meningioma patients: improving patient selection for antiepileptic drug therapy

et al. 2018

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BackgroundEpilepsy is a major cause of morbidity and mortality in meningioma patients. The aims of this study were to determine which factors predispose meningioma patients to developing perioperative seizures and to understand the impact of antiepileptic drugs.MethodsPatients treated for a histologically-confirmed intracranial meningioma at the authors’ institution between 2010 and 2015 were retrospectively examined. Clinical and imaging data were assessed. Multivariate analysis was performed using binary logistic regression. The effect of antiepileptic treatment was assessed using survival analysis.ResultsTwo hundred and eighty-three patients met the selection criteria; seizures were present in 68 preoperatively (24%) and in 48 patients (17%) following surgery. Of the 68 with preoperative seizures, 19 continued to have them, whereas de-novo seizures arose postoperatively in 29 seizure-naïve patients. Risk factors of postoperative seizures were convexity location (OR 2.05 [95% CI 1.07–3.98], p = 0.030), fronto-parietal location (OR 4.42 [95% CI 1.49–13.16], p = 0.007) and preoperative seizures (OR 2.65 [95% CI 1.37–5.24], p = 0.005). The two locations, in addition to the presence of midline shift on preoperative imaging (OR 4.15 [95% CI 1.54–11.24], p = 0.005), were significantly correlated with postoperative seizures in seizure-naïve patients. Antiepileptic treatment in patients with those risk factors reduced the possibility of seizures at any time point within the 1st year postoperatively by approximately 40%, although this did not meet statistical significance.ConclusionProphylactic antiepileptic treatment might be warranted in seizure-naïve meningioma patients with ≥ 1 risk factor. High-quality randomised controlled trials are required to verify those factors and to define the role of antiepileptics in meningioma practice.

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“…With the development of medical imaging techniques, an increasing number of brain tumours may be identified in the early stages. Seizures were more commonly associated with primary than secondary tumours, such as glioma and meningioma [ 37 , 38 ]. Hippocampus sclerosis was less common in elderly epileptic patients, and this finding is in accordance with previous literature [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Aetiological Features of Elderly Patients with Newly Diagnosed Symptomatic Epilepsy in Western China

Guo

et al. 2018

BioMed Research International

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Aims Recent epidemiological studies have indicated that the incidence of epilepsy peaks after 60 years old, and epilepsy has become increasingly prevalent in elderly populations. The aim of this study is to identify the aetiologic characteristics of epilepsy in the elderly. Methods We retrospectively recruited elderly patients with newly diagnosed epilepsy identified in three epilepsy centres in western China; elderly patients were defined as individuals aged 60 years or older. Demographic characteristics, clinical epilepsy data, and the diagnosis and aetiology of epilepsy were recorded. Results A total of 760 patients with newly diagnosed epilepsy were enrolled in our study. Of these patients, 25% had experienced one or more episodes of status epilepticus, and 62.4% were confirmed as symptomatic. Among the symptomatic cohort, stroke and traumatic brain injury (TBI) were the two most common causes of epilepsy, followed by cerebral tumour, dementia, hippocampal sclerosis (HS), and central nervous system (CNS) infection. When analysed by residence and age, ischaemic stroke was the most common cause of epilepsy in urban patients, whereas traumatic brain injury was the leading cause of epilepsy in rural patients. Conclusion More than three-fifths of newly diagnosed epilepsy cases in elderly patients were confirmed as symptomatic, and stroke and traumatic brain injury were the primary aetiologies in elderly epileptic patients.

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Epilepsy and adverse quality of life in surgically resected meningioma

Cited by 32 publications

References 32 publications

Life after surgical resection of a meningioma: a prospective cross-sectional study evaluating health-related quality of life

Life after surgical resection of a meningioma: a prospective cross-sectional study evaluating health-related quality of life

Postoperative seizures in meningioma patients: improving patient selection for antiepileptic drug therapy

Aetiological Features of Elderly Patients with Newly Diagnosed Symptomatic Epilepsy in Western China

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