Seizures in supratentorial meningioma

A systematic review and meta-analysis

Dario J. Englot, Stephen T. Magill, Seunggu (Jude) Han, Edward F. Chang, Mitchel S. Berger, Michael W. McDermott

Research output: Contribution to journalReview article

35 Citations (Scopus)

Abstract

Objective Meningioma is the most common benign intracranial tumor, and patients with supratentorial meningioma frequently suffer from seizures. The rates and predictors of seizures in patients with meningioma have been significantly under-studied, even in comparison with other brain tumor types. Improved strategies for the prediction, treatment, and prevention of seizures in patients with meningioma is an important goal, because tumor-related epilepsy significantly impacts patient quality of life. methods The authors performed a systematic review of PubMed for manuscripts published between January 1980 and September 2014, examining rates of pre-and postoperative seizures in supratentorial meningioma, and evaluating potential predictors of seizures with separate meta-analyses. results The authors identified 39 observational case series for inclusion in the study, but no controlled trials. Preoperative seizures were observed in 29.2% of 4709 patients with supratentorial meningioma, and were significantly predicted by male sex (OR 1.74, 95% CI 1.30-2.34); an absence of headache (OR 1.77, 95% CI 1.04-3.25); peritumoral edema (OR 7.48, 95% CI 6.13-9.47); and non-skull base location (OR 1.77, 95% CI 1.04-3.25). After surgery, seizure freedom was achieved in 69.3% of 703 patients with preoperative epilepsy, and was more than twice as likely in those without peritumoral edema, although an insufficient number of studies were available for formal meta-analysis of this association. Of 1085 individuals without preoperative epilepsy who underwent resection, new postoperative seizures were seen in 12.3% of patients. No difference in the rate of new postoperative seizures was observed with or without perioperative prophylactic anticonvulsants. coNclusioNs Seizures are common in supratentorial meningioma, particularly in tumors associated with brain edema, and seizure freedom is a critical treatment goal. Favorable seizure control can be achieved with resection, but evidence does not support routine use of prophylactic anticonvulsants in patients without seizures. Limitations associated with systematic review and meta-analysis should be considered when interpreting these results.

Original languageEnglish (US)
Pages (from-to)1552-1561
Number of pages10
JournalJournal of neurosurgery
Volume124
Issue number6
DOIs
StatePublished - Jun 1 2016
Externally publishedYes

Fingerprint

Meningioma
Meta-Analysis
Seizures
Epilepsy
Anticonvulsants
Edema
Neoplasms
Manuscripts
Brain Edema
PubMed
Brain Neoplasms
Headache
Quality of Life

Keywords

  • Epilepsy
  • Meningioma
  • Oncology
  • Predictor
  • Seizure
  • Surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Englot, D. J., Magill, S. T., Han, S. J., Chang, E. F., Berger, M. S., & McDermott, M. W. (2016). Seizures in supratentorial meningioma: A systematic review and meta-analysis. Journal of neurosurgery, 124(6), 1552-1561. https://doi.org/10.3171/2015.4.JNS142742

Seizures in supratentorial meningioma : A systematic review and meta-analysis. / Englot, Dario J.; Magill, Stephen T.; Han, Seunggu (Jude); Chang, Edward F.; Berger, Mitchel S.; McDermott, Michael W.

In: Journal of neurosurgery, Vol. 124, No. 6, 01.06.2016, p. 1552-1561.

Research output: Contribution to journalReview article

Englot, DJ, Magill, ST, Han, SJ, Chang, EF, Berger, MS & McDermott, MW 2016, 'Seizures in supratentorial meningioma: A systematic review and meta-analysis', Journal of neurosurgery, vol. 124, no. 6, pp. 1552-1561. https://doi.org/10.3171/2015.4.JNS142742
Englot, Dario J. ; Magill, Stephen T. ; Han, Seunggu (Jude) ; Chang, Edward F. ; Berger, Mitchel S. ; McDermott, Michael W. / Seizures in supratentorial meningioma : A systematic review and meta-analysis. In: Journal of neurosurgery. 2016 ; Vol. 124, No. 6. pp. 1552-1561.
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abstract = "Objective Meningioma is the most common benign intracranial tumor, and patients with supratentorial meningioma frequently suffer from seizures. The rates and predictors of seizures in patients with meningioma have been significantly under-studied, even in comparison with other brain tumor types. Improved strategies for the prediction, treatment, and prevention of seizures in patients with meningioma is an important goal, because tumor-related epilepsy significantly impacts patient quality of life. methods The authors performed a systematic review of PubMed for manuscripts published between January 1980 and September 2014, examining rates of pre-and postoperative seizures in supratentorial meningioma, and evaluating potential predictors of seizures with separate meta-analyses. results The authors identified 39 observational case series for inclusion in the study, but no controlled trials. Preoperative seizures were observed in 29.2{\%} of 4709 patients with supratentorial meningioma, and were significantly predicted by male sex (OR 1.74, 95{\%} CI 1.30-2.34); an absence of headache (OR 1.77, 95{\%} CI 1.04-3.25); peritumoral edema (OR 7.48, 95{\%} CI 6.13-9.47); and non-skull base location (OR 1.77, 95{\%} CI 1.04-3.25). After surgery, seizure freedom was achieved in 69.3{\%} of 703 patients with preoperative epilepsy, and was more than twice as likely in those without peritumoral edema, although an insufficient number of studies were available for formal meta-analysis of this association. Of 1085 individuals without preoperative epilepsy who underwent resection, new postoperative seizures were seen in 12.3{\%} of patients. No difference in the rate of new postoperative seizures was observed with or without perioperative prophylactic anticonvulsants. coNclusioNs Seizures are common in supratentorial meningioma, particularly in tumors associated with brain edema, and seizure freedom is a critical treatment goal. Favorable seizure control can be achieved with resection, but evidence does not support routine use of prophylactic anticonvulsants in patients without seizures. Limitations associated with systematic review and meta-analysis should be considered when interpreting these results.",
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