Publication year: 2012
Source:World Neurosurgery
Kaisorn L. Chaichana, Courtney Pendleton, Hasan Zaidi, Alessandro Olivi, Jon D. Weingart, Gary L. Gallia, Michael Lim, Henry Brem, Alfredo Quinones-Hinojosa
Objective Seizures are common among patients with meningiomas and are a significant cause of morbidity and poor quality of life. The factors associated with the onset of seizures as well as factors associated with seizure control remains poorly understood. Methods Adult patients who underwent primary resection of a supratentorial World Health Organization grade I meningioma at a single institution between 1996 and 2006 were retrospectively reviewed. Multivariate logistical regression analysis was used to identify associations with pre-operative seizures, and multivariate proportional hazards regression analyses were used to identify associations with prolonged seizure control following surgical resection. Results Of the 626 patients in this series, 84 (13%) presented with seizures. The factors independently associated with pre-operative seizures were: Karnofsky performance score (KPS) ≤ 80 (p<0.0001), absence of headaches (p=0.0006), and vasogenic edema (p=0.007). At 48-months post-operatively, 90% were Engel Class I, 3% were Class II, 0% were Class III, and 7% were Class IV. The factors independently associated with decreased seizure control following surgical resection were: uncontrolled pre-operative seizures (p=0.04), parasagittal tumors (p=0.03), and tumors along the sphenoid wing (p=0.05). The association between seizure recurrence and tumor recurrence trended towards but did not achieve statistical significance (p=0.11). Conclusion With the widespread availability of various neuro-imaging modalities, there will be increased detection of intracranial meningiomas. The identification and consideration of factors associated with seizure onset and prolonged seizure control may help guide treatment strategies aimed at improving the quality of life for patients with meningiomas.
Source:World Neurosurgery
Kaisorn L. Chaichana, Courtney Pendleton, Hasan Zaidi, Alessandro Olivi, Jon D. Weingart, Gary L. Gallia, Michael Lim, Henry Brem, Alfredo Quinones-Hinojosa
Objective Seizures are common among patients with meningiomas and are a significant cause of morbidity and poor quality of life. The factors associated with the onset of seizures as well as factors associated with seizure control remains poorly understood. Methods Adult patients who underwent primary resection of a supratentorial World Health Organization grade I meningioma at a single institution between 1996 and 2006 were retrospectively reviewed. Multivariate logistical regression analysis was used to identify associations with pre-operative seizures, and multivariate proportional hazards regression analyses were used to identify associations with prolonged seizure control following surgical resection. Results Of the 626 patients in this series, 84 (13%) presented with seizures. The factors independently associated with pre-operative seizures were: Karnofsky performance score (KPS) ≤ 80 (p<0.0001), absence of headaches (p=0.0006), and vasogenic edema (p=0.007). At 48-months post-operatively, 90% were Engel Class I, 3% were Class II, 0% were Class III, and 7% were Class IV. The factors independently associated with decreased seizure control following surgical resection were: uncontrolled pre-operative seizures (p=0.04), parasagittal tumors (p=0.03), and tumors along the sphenoid wing (p=0.05). The association between seizure recurrence and tumor recurrence trended towards but did not achieve statistical significance (p=0.11). Conclusion With the widespread availability of various neuro-imaging modalities, there will be increased detection of intracranial meningiomas. The identification and consideration of factors associated with seizure onset and prolonged seizure control may help guide treatment strategies aimed at improving the quality of life for patients with meningiomas.
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