Risk Factors of Preoperative and Early Postoperative Seizures in Patients with Meningioma: A Retrospective Single-Center Cohort Study

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• 作者：Marco Skardelly¹ ; ⁷ ; ^{marco.skardelly@med.uni-tuebingen.de} ; Christian Rother¹ ; ⁷ ; Susan Noell¹ ; ⁷ ; Felix Behling¹ ; ⁷ ; Thomas V. Wuttke¹ ; ² ; ⁷ ; Jens Schittenhelm³ ; ⁷ ; Sotirios Bisdas⁴ ; ⁷ ; Christoph Meisner⁵ ; Sabine Rona¹ ; Ghazaleh Tabatabai¹ ; ⁶ ; ⁷ ; ⁸ ; ⁹ ; Florian Roser¹ ; ¹ ; Marcos Soares Tatagiba¹ ; ⁷
• 关键词：Antiepileptic drugs ; Effect size ; Epilepsy ; Meningioma ; Risk factor ; Seizure
• 刊名：World Neurosurgery
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：97
• 期：Complete
• 页码：538-546
• 全文大小：8303 K
• 卷排序：97

文摘

Well-defined risk factors for the identification of patients with meningioma who might benefit from preoperative or early postoperative seizure prophylaxis are unknown. We investigated and quantified risk factors to determine individual risks of seizure occurrence in patients with meningioma.MethodsA total of 634 adult patients with meningioma were included in this retrospective cohort study. Patient gender and age, tumor location, grade and volume, usage of antiepileptic drugs (AEDs) and extent of resection were determined.ResultsPreoperative and early postoperative seizures occurred in 15% (n = 97) and 5% (n = 21) of the patients, respectively. Overall, 502 and 418 patients were eligible for multivariate logistic regression analyses of preoperative and early postoperative seizures, respectively. Male gender (odds ratio [OR], 2.06; P = 0.009), a non-skull base location (OR, 4.43; P < 0.001), and a tumor volume of >8 cm3 (OR, 3.05; P = 0.002) were associated with a higher risk of preoperative seizures and were used to stratify the patients into 3 prognostic groups. The high-risk subgroup of patients with meningioma showed a seizure rate of >40% (OR, 9.8; P < 0.001). Only a non-skull base tumor location (OR, 2.61; P = 0.046) was identified as a significant risk factor for early postoperative seizures. AEDs did not reduce early postoperative seizure occurrence.ConclusionsSeizure prophylaxis might be considered for patients at high risk of developing seizures who are for other reasons being considered for watchful waiting instead of resection. In contrast, our data do not provide any evidence of the efficacy of perioperative AEDs in patients with meningioma.