Risk factors and control of seizures in 778 Chinese patients undergoing initial resection of supratentorial meningiomas

AbstractThis retrospective study explored the risk factors for the occurrence of seizures in the pre- and postoperative period in patients undergoing supratentorial meningiomas surgery to investigate those who are likely to benefit from prophylactic antiepileptic drugs (AEDs). We reviewed the medical records of 778 supratentorial meningiomas patients who were operated at our institution between 2011 and 2012. A total of 100 (12.9%) patients experienced preoperative seizures; 41 patients (5.3%) experienced postoperative in-hospital seizures, and 91 (13.5%,n = 673) patients experienced postoperative seizures after discharge. Multivariate analysis revealed that motor cortex involvement (odds ratio [OR] 3.243,P <  0.001) and peritumoral edema ≥ 1 cm (OR 3.936,P <  0.001) were significant risk factors of preoperative seizures. Whereas presenting with headache (OR 0.259,P <  0.001) and age ≥ 55 years at surgery (OR 0.514,P  = 0.009) showed decreased incidence of preoperative seizures. The involvement of motor cortex (OR 3.290,P = 0.003), postoperative Karnofsky Performance Scale (KPS) ≤ 70 (OR 5.389,P <  0.001), preoperative seizure (OR 4.003,P  < 0.001), and occurrence of any medical/surgical complication (OR 3.925,P = 0.001) were significant risk factors for postoperative in-hospital seizures. Postoperative seizures after discharge were associated with tumor maximal diameter ≥ 3.5 cm (OR 1.903,P = 0.022), pre...
Source: Neurosurgical Review - Category: Neurosurgery Source Type: research