Factors associated with preoperative and early and late postoperative seizures in patients with supratentorial meningiomas

Abstract

Objective: Risk factors for epilepsy in meningioma patients are not yet clearly defined, however, seizure freedom is a significant factor for quality of life after surgery. Methods:We performed a retrospective study of the 333 adult patients who received surgery for supratentorial meningioma at our center. Various clinical, radiological, and surgical variables were included in the multivariate regression, and the outcomes measured were the occurrence of seizure(s) preoperatively, during the hospitalization, and during the follow-up period.Results: A total of 89 (26.7%) patients experienced preoperative seizures, of whom 62.9% were seizure free after the surgery. Of 244 patients without epilepsy before surgery, 11.9% had at least one seizure postoperatively. In total, 63 of our patients (18.9%) experienced seizures after the surgery, of whom 20 had refractory epilepsy.Multivariate analysis identified the following predictors of preoperative seizures: the

Meningioma-Related Epilepsy: A Happy Ending?

“…In our study, frequency of pre-operative meningioma-related seizures does not differ from data reported in the literature, affecting 20.4% of the entire population. Large previous and recent studies observed a percentage between 12.9% and 31.3% [3,9,[19][20][21]. Demographic, clinical and radiological characteristics of patients are also in line with the literature [2,18,19,[22][23][24][25][26] (Table 6).…”

“…Large previous and recent studies observed a percentage between 12.9% and 31.3% [3,9,[19][20][21]. Demographic, clinical and radiological characteristics of patients are also in line with the literature [2,18,19,[22][23][24][25][26] (Table 6).…”

“…There are controversial data regarding gender as a risk factor for pre-operative meningioma-related seizures; in fact, some authors observed a prevalence of seizures in females [27], while others reported a prevalence in males [8,28]. Furthermore, there are also studies that did not find any association between gender and meningioma-related seizures, as in our population [19,21,27]. Our results may depend on sample size, which presents a globally equal distribution in gender.…”

“…Chaichana et al [28] reported that the presence of peritumoral edema at pre-surgical imaging increased the possibility to develop pre-operative seizures by a factor of three. Li et al [9] identified peritumoral edema >/= 1 cm as one of the risk factors for pre-operative seizures, as well as in Bogdanovic's recent work [19]. Edema may enhance seizures, determining neuronal death and excitotoxicity, by mean of mass effect on cerebral cortex.…”

“…Predictors and outcomes of meningioma-related epilepsy remain understudied, probably because most investigations have been dealing mainly with surgical aspects and prevention of neurological deficits. However, regardless of whether or not seizures may respond to ASMs, they represent a significant cause of morbidity and poor quality of life [9,18,19]. Therefore, proper understanding of these features is imperative to preventing seizure occurrence and guiding treatment strategies for patients with intracranial meningiomas.…”