Predictive factors for seizures accompanying intracranial meningiomas

Abstract

Objective: Seizures represent a common manifestation of intracranial meningiomas. Their predictive factors before and after excision merit studying. Materials and Methods: Patients having intracranial meningioma were prospectively studied. There were two groups; Group “A” with seizures and Group “B” with no preoperative epilepsy. Results: This study included 40 patients. Their ages ranged from 40 to 60 years old, and female-to-male ratio was 2.3:1 in both groups. In Group A, partial seizures were the most common pattern (60%). Manifestations other than fits included headache in most patients (97.5%), symptoms of increased intracranial pressure were found in 50% in Group A and 20% in Group B patients, peritumoral edema was present in 14 (70%) patients of Group A, compared to 6 (25%) patients of Group “B.” There was a statistically significant relation between peritumoral edema and presentation with fits ( P < 0.1). Complication after surgery included nonsurgical hematoma in three patients and contusion in 7 patients. Following surgery for Group “A”, 8 (40%) patients had good seizure control. While, in Group “B” 3 (15%), patients developed new-onset seizures. Good seizure control in 7 (53%) patients with frontal, frontotemporal tumors than in other locations. In addition, better control was obtained in left sided, small tumors, and no peritumoral edema. Postoperative complication was significantly associated with new-onset epilepsy and poor seizure control ( P < 0.05). Neither tumor size nor location had a significant relation to either pre or postoperative epilepsy. Conclusion: Predictive factors for epilepsy accompanying intracranial meningioma included males, elderly patients and patients with small lesions, frontal and left-sided locations but were statistically insignificant predictors. Peritumoral edema and postoperative complications are the most significant predictors.

The Effect of the Presence of Epileptic Attacks on the Clinical Duration of Supratentorial Brain Meningiomas

“…However, a number of publications have noted the prevalence and progression of patients. There have been a number of predictors of the persistence of seizures after surgery, such as swelling around the tumour and the male [7,8,9].…”

Tumor-Related Epilepsy and Post-Surgical Outcomes: Tertiary Hospital Experience in Vietnam

“…The similarity was found in other observations, peritumoral edema is a major epileptogenic factor in brain tumors. [13][14][15] The mechanism involves the mechanism of cerebral edema, which is caused by the association between vasomotor and cytotoxic disturbances. Intrinsic tumor hypoxia produces metabolic acidosis in the interstitial tissue and increases vascular endothelial permeability.…”

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

“…Glutamate has been associated with preoperative seizures in almost all studies in which it has been investigated. 4,5,7,8,15,18,19,21 Peritumoral edema might also be accompanied by brain invasion. 15 Older age as a risk factor for preoperative seizures could be shown in one study, 5 while significance was not demonstrated in other studies.…”

“…It is still unclear whether prophylactic preoperative and perioperative antiseizure treatment is worthwhile and which patients are likely to experience seizures in the course of the disease. Several studies and meta‐analyses have addressed this question 2–9,12–24 . However, the results are not always conclusive, and the factors associated with preoperative and postoperative seizures are heterogeneous.…”

“…Several studies and meta-analyses have addressed this question. [2][3][4][5][6][7][8][9][12][13][14][15][16][17][18][19][20][21][22][23][24] However, the results are not always conclusive, and the factors associated with preoperative and postoperative seizures are heterogeneous. The aim of this study was to identify factors associated with preoperative and postoperative seizures in patients undergoing primary resection of supratentorial meningiomas in a single center, with an emphasis on separate analyses of early and late postoperative seizures.…”