Acta Neurochirurgica

, Volume 160, Issue 3, pp 589–596 | Cite as

Long-term control and predictors of seizures in intracranial meningioma surgery: a population-based study

  • Hai Xue
  • Olafur Sveinsson
  • Jiri BartekJr
  • Petter Förander
  • Simon Skyrman
  • Lars Kihlström
  • Raana Shafiei
  • Tiit Mathiesen
  • Torbjörn Tomson
Original Article - Brain Tumors
  • 77 Downloads

Abstract

Background

The aim of this retrospective study was to investigate the long-term seizure control and antiepileptic drug (AED) prescriptions, as well as identifying predictors of seizure(s) before and after surgery in a population-based cohort of operated intracranial meningioma patients.

Methods

A total of 113 consecutive adult (> 18 years old) patients with newly diagnosed meningioma operated at the Karolinska University Hospital between 2006 and 2008 were included and followed up until the end of 2015. Data on seizure activity and AED prescriptions were obtained through chart review and telephone interview. Logistic regression and survival analysis were applied to identify risk factors for pre- and postoperative seizures.

Results

A total of 21/113 (18.6%) patients experienced seizures before surgery of which 8/21 (38.1%) went on to become seizure-free after surgery. Thirteen (14%) patients experienced new-onset seizures after surgery. The regression analysis revealed tumor diameter ≥ 3.5 cm as a risk factor for preoperative seizures (OR 3.83, 95% CI 1.14–12.87). Presence of headache (OR 0.19, 95% CI 0.05–0.76) and skull base tumor location (OR 0.14, 95% CI 0.04–0.44) decreased the risk of preoperative seizures. Postoperative seizures were associated with tumor diameter ≥ 3.5 cm (OR 2.65, 95% CI 1.06–6.62) and history of preoperative seizures (OR 3.50, 95% CI 1.55–7.90).

Conclusion

Seizures are common before and after intracranial meningioma surgery. Approximately one third of patients with preoperative seizures become seizure-free on long-term follow-up after surgery, while 14% experienced new-onset seizures after surgery. Larger tumor size, absence of headache, and non-skull base location were associated with preoperative seizures, while tumor size and preoperative seizures were associated with postoperative seizures.

Keywords

Intracranial meningioma Seizure Epilepsy Risk factors Antiepileptic drugs 

Notes

Compliance with ethical standards

The study was approved by the ethics committee of Karolinska Institutet.

Disclosure

The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical considerations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Hai Xue
    • 1
    • 2
  • Olafur Sveinsson
    • 3
  • Jiri BartekJr
    • 2
    • 4
    • 5
  • Petter Förander
    • 4
  • Simon Skyrman
    • 4
  • Lars Kihlström
    • 4
  • Raana Shafiei
    • 3
  • Tiit Mathiesen
    • 2
    • 4
    • 5
  • Torbjörn Tomson
    • 2
    • 3
  1. 1.Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingPeople’s Republic of China
  2. 2.Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
  3. 3.Department of NeurologyKarolinska University HospitalStockholmSweden
  4. 4.Department of NeurosurgeryKarolinska University HospitalStockholmSweden
  5. 5.Department of NeurosurgeryCopenhagen University Hospital RigshospitaletCopenhagenDenmark

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