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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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Predictors for pre- and postoperative seizures in meningioma patients

Meeting Abstract

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  • Marco Skardelly - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • Christian Rother - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • Susan Noell - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • Jens Schittenhelm - Abteilung für Neuropathologie, Institut für Pathologie und Neuropathologie, Universitätsklinikum Tübingen
  • Marcos Tatagiba - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • Florian Roser - Klinik für Neurochirurgie, Universitätsklinikum Tübingen

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMI.16.06

doi: 10.3205/14dgnc365, urn:nbn:de:0183-14dgnc3655

Published: May 13, 2014

© 2014 Skardelly et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: The application of antiepileptic drugs is not effective in the prevention of initial seizures in meningioma patients. Hence, the routine application of antiepileptic drugs in newly diagnosed meningioma is not recommended. Up to date, the risk factors to develop a seizure have not been thoroughly explored. In this study, we investigated the predictors for the occurrence of pre- and postoperative seizures in meningioma patients.

Method: A retrospective analysis was performed to find out the predictors for pre- and postoperative seizures at the Department of Neurosurgery in patients with meningioma, who underwent surgery between 01-2009 and 12-2012. Uni- and multivariate analysis included age, gender, tumor location (skull base vs other (convexity-, parasagittal- and falx-meningioma)), WHO-grade (I & II), as well as tumor and edema volume as pre- and postoperative predictors. Preoperative seizures and administration of antiepileptic drugs were also included as postoperative predictors.

Results: 634 patients were operated, of which 124 (20%) presented with a history of at least one seizure, 97 (15%) pre- and 44 (7%) postoperatively. Although, univariate observations showed an obvious impact of gender, tumor location, WHO-grade and tumor volume for the occurrence of preoperative seizures, only gender (p=0.0089) and tumor location (p<0.001) and tumor volume (p=0.0034) proved to be significant in multivariate analysis (N=502). For postoperative seizures, we observed an apparent univariate influence of preoperative seizures, perioperative antiepileptic drugs, tumor location, WHO-grade, simpson grade and tumor volume. Nevertheless, only tumor volume (p=0.022) demonstrated a significant effect in multivariate analysis (N=497).

Conclusions: Our results confirm that the perioperative application of antiepileptic drugs is not effective in preventing postoperative seizures in meningioma patients. Male gender and other than skull base meningioma were found to be risk factors developing a preoperative seizure. Because both are not attributed to WHO-grade or tumor edema volume, the pathophysiological concept remains unclear. Postoperative seizures are only correlated to the tumor volume, which could be explained by the more extensive peri-lesional damage due to surgical removal in greater tumor size.