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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

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Factors influencing seizure outcome after resection of atypical and anaplastic meningioma in patients with preoperative tumor-associated epilepsy – a single-center series

Anfallsoutcome bei Patienten mit atypischen und anaplastischen Meningeomen und präoperativ symptomatischen Anfällen

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  • presenting/speaker Matthias Schneider - Universitätsklinikum Bonn, Klinik für Neurochirurgie, Bonn, Deutschland
  • Ági Güresir - Universitätsklinikum Bonn, Klinik für Neurochirurgie, Bonn, Deutschland
  • Valeri Borger - Universitätsklinikum Bonn, Klinik für Neurochirurgie, Bonn, Deutschland
  • Motaz Hamed - Universitätsklinikum Bonn, Klinik für Neurochirurgie, Bonn, Deutschland
  • Hartmut Vatter - Universitätsklinikum Bonn, Klinik für Neurochirurgie, Bonn, Deutschland
  • Erdem Güresir - Universitätsklinikum Bonn, Klinik für Neurochirurgie, Bonn, Deutschland
  • Patrick Schuss - Universitätsklinikum Bonn, Klinik für Neurochirurgie, Bonn, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV272

doi: 10.3205/19dgnc291, urn:nbn:de:0183-19dgnc2913

Published: May 8, 2019

© 2019 Schneider et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Both pre- and postoperative seizures comprise common side effects that negatively impact quality of life in patients suffering from intracranial meningioma. Therefore, seizure freedom represents an important outcome measure in meningioma surgery. In the current study we analyzed our institutional database in order to identify risk factors for postoperative seizure occurrence after surgical therapy of atypical and anaplastic meningioma in patients with preoperative symptomatic epilepsy.

Methods: Between 2009 and 2017, 47 patients with WHO grade II or III meningiomas and preoperative seizures underwent resection of a supratentorial meningioma at the authors’ institution. Seizure outcome was assessed retrospectively twelve months after tumor resection according to the International League Against Epilepsy (ILAE) classification and stratified into favorable (ILAE class I) versus unfavorable (ILAE classes II–VI). An univariate analysis was performed to identify factors influencing unfavorable seizure outcome.

Results: Overall 38 of 47 patients with preoperative seizures achieved a favorable outcome (81%) in terms of seizure freedom after meningioma resection. Univariate analysis revealed tumoral sinus infiltration (p=0.001), marked peritumoral edema (p=0.03), a low extent of tumor resection in terms of Simpson grades III to V (p=0.001) as well as postoperative tumor progression (p=0.01) as factors associated with a postoperative unfavorable seizure outcome.

Conclusion: Surgery is highly effective in the treatment of seizures as common side effects of WHO grade II and III meningioma. Furthermore, the present study identifies several factors for postoperative seizure occurrence enabling to select for high risk patients that require special attention in clinical and surgical management.