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

Ivan Bogdanovic; Aleksandar Ristic; Rosanda Ilic; Vladimir Bascarevic; Zoran Bukumiric; Aleksandar Miljkovic; Filip Milisavljevic; Aleksandar Stepanovic; Igor Lazic; Danica Grujicic

doi:10.1002/epd2.20021

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

Epileptic Disord. 2023 Apr;25(2):244-254. doi: 10.1002/epd2.20021. Epub 2023 May 6.

Authors

Ivan Bogdanovic^{1

2}, Aleksandar Ristic^{2

3}, Rosanda Ilic^{1

2}, Vladimir Bascarevic^{1

2}, Zoran Bukumiric^{2

4}, Aleksandar Miljkovic¹, Filip Milisavljevic¹, Aleksandar Stepanovic^{2

5}, Igor Lazic¹, Danica Grujicic^{1

2}

Affiliations

¹ Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia.
² School of Medicine, University of Belgrade, Belgrade, Serbia.
³ Clinic for Neurology, University Clinical Center of Serbia, Belgrade, Serbia.
⁴ Institute for Medical Statistics and Informatics, University of Belgrade Faculty of Medicine, Belgrade, Serbia.
⁵ Institute for Oncology and Radiology of Serbia, Belgrade, Serbia.

PMID: 36939715
DOI: 10.1002/epd2.20021

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 absence of headache (OR: 0.23, CI: 2.55-8.50), the presence of significant peritumoral edema (OR: 4.35, CI: 2.57-7.35), and younger age (OR: 0.97 per year increase, CI: 0.95-0.99). Factors associated with early postoperative seizures were: younger age (OR: 0.96 per year increase, CI: 0.93-0.99) and the presence of preoperative seizures (OR: 2.73, CI: 1.13-6.57), while the presence of preoperative seizures (OR: 4.73, CI: 2.05-10.92), tumor progression (OR: 5.38, CI: 2.25-12.89), and neurological worsening (OR: 5.21 CI: 1.72-15.81) were significant for late postoperative seizures.

Significance: Our results from a single-center meningioma cohort confirm, in general, data from some previous studies regarding patients' characteristics for both preoperative and overall postoperative epilepsy. Besides previously described risk factors, younger age was important for preoperative and early postoperative seizures. Epilepsy is common in patients with recurrence of meningioma, but the variables of significance for refractory seizures in these patients require further examination.

Keywords: epilepsy; predictor; surgery; tumor.

MeSH terms

Adult
Epilepsy* / complications
Humans
Meningeal Neoplasms* / complications
Meningeal Neoplasms* / surgery
Meningioma* / complications
Meningioma* / diagnosis
Meningioma* / surgery
Postoperative Complications / diagnosis
Postoperative Complications / epidemiology
Postoperative Complications / etiology
Quality of Life
Retrospective Studies
Seizures / complications
Supratentorial Neoplasms* / complications
Supratentorial Neoplasms* / diagnosis
Supratentorial Neoplasms* / surgery
Treatment Outcome