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Risk factors for preoperative and late postoperative seizures in primary supratentorial meningiomas.

Abstract：

OBJECTIVE:We performed a retrospective study to identify factors associated with preoperative and late postoperative seizures in primary supratentorial meningiomas. PATIENTS AND METHODS:Between July 2003 and December 2014, we extracted 303 consecutive patients who underwent primary resection for supratentorial meningiomas at a single institution. Univariate analysis and multivariate logistic regression analysis were performed to determine the associations of seizure occurrence and outcome. RESULTS:Forty-nine (16.2%) of the total 303 patients presented with preoperative seizures. The risk factors independently associated with preoperative seizures were vasogenic edema (OR 4.44, p = 0.001), parasagittal or parafalcine location (OR 2.20, p = 0.020), and absence of neurologic deficit (OR 0.30, p = 0.003). Among these patients, 33 (67.3%) were seizure free postoperatively (Engel Class I). Of the 303 patients, we observed late postoperative seizures in 35 (11.6%) patients. The associated risk factors included history of preoperative seizure (OR 3.96, p = 0.002), bigger tumor size (OR 1.04, p = 0.002), and continuation of anti-epileptic drugs (OR 4.74, p = 0.001). We analyzed that meningiomas with a largest diameter of greater than 45.5 mm were 4.2 times more likely to have late postoperative seizures than those with less diameter (HR 4.20, p < 0.001). Ten (28.6%) of the 35 patients with late postoperative seizures experienced poor seizure control. The independently associated predictive factors were high grade meningiomas (WHO Grade II or III) (OR 10.66, p = 0.030) and history of postoperative adjuvant therapy (OR 12.58, p = 0.040). CONCLUSIONS:Identifying factors associated with preoperative or late postoperative seizures may help guide treatment strategies, eventually improving the quality of life for patients with meningiomas.

journal_name

Clin Neurol Neurosurg

journal_title

Clinical neurology and neurosurgery

authors

Hwang K,Joo JD,Kim YH,Han JH,Oh CW,Yun CH,Park SH,Kim CY

doi

10.1016/j.clineuro.2019.03.007

subject

Has Abstract

pub_date

2019-05-01 00:00:00

pages

34-39

eissn

0303-8467

issn

1872-6968

pii

S0303-8467(19)30062-9

journal_volume

180

pub_type

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Risk factors for preoperative and late postoperative seizures in primary supratentorial meningiomas.