Characterizing Patient Populations at Risk for Postoperative Seizure after Primary Meningioma Resection

Introduction: Postoperative seizures after resection of a primary meningioma are uncommon, even when seizures are a preoperative presenting symptom. Understanding risk factors for postoperative seizures can help guide clinical decision making for prophylactic AED usage in the postoperative period.

Objective: We conducted a single center retrospective review of patients with primary meningioma resection to characterize the patient profile at risk of experiencing postoperative seizure.

Materials and Method: Clinical and demographic data was extracted from an institutional tissue bank of patients who underwent primary meningioma resection between 1995 and 2018. Only primary meningioma patients experiencing post resection seizure were included in the cohort. Descriptive statistics were used to analyze these cohort characteristics.

Results: Of the 146 patients in the cohort, 35 (24.0%) patients experienced a postoperative seizure. Their median age was 62.48 years (standard deviation = 13.94) and 24 (68.6%) were female. 7 (20%) of tumors were Grade 1, 26 (74.3%) were Grade 2, 2 (5.7%) were Grade 3, and 26 (74.3%) were classified as convexity meningiomas. Total surgical resection was achieved in 20 (57.1%) patients. Overall, 12 (34.3%) patients experienced postoperative complications. Of those who experienced complications, 9 (25.7%) had hemorrhage and 2, (5.7%) postoperative hydrocephalus. 15 (42.9%) experienced the postoperative seizure within 6 months of surgical resection. Sixteen (45.7%) patients also experienced a preoperative seizure.

Conclusion: Our data suggests that the patients at greatest risk for postoperative seizures have Grade 2 tumors and are older. Notably, although not significant, patients with preoperative seizure tended to experience postoperative seizures at greater frequency compared with those who did not have preoperative seizures. Further research is warranted to understand how these factors influence risk of postoperative seizure to inform clinical decision making around AED prophylaxis.

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Artikel online veröffentlicht:
07. Februar 2025