Meningioma-Related Epilepsy: A Happy Ending?

Abstract

(1) Background: More than one-third of patients with meningiomas experience at least one seizure during the course of their disease, and in the 20-50% of cases, seizure represents the onset symptom. After surgery, up to 30% of patients continue to have seizures, while others may experience them later; (2) Methods: The study analyzed retrospectively the risk factors for pre-operative seizures in a large cohort of 358 patients who underwent surgery for newly diagnosed brain meningioma; (3) Results: We identified age, peritumor edema, and location as risk factors for seizure at the onset. Patients with seizures differed from patients without seizures for the following characteristics: younger average age, lower pre-operative Karnofsky Performance Status (KPS), location on the convexity, lower Simpson Grade, lower incidence of pre-operative neurological deficits, and higher incidence of pre-operative peritumor edema. After 24 months, 88.2% of patients were classified as Engel class Ia, and no correlation with disease progression was observed; (4) Conclusions: Meningioma-related epilepsy has generally a positive outcome following surgery and it seems not to be linked to disease progression, even if further studies are needed.

Keywords: epilepsy; meningioma; oncology; predictors; seizure; surgery.

Figure 1

A brain MRI of a patient with left frontal meningioma. (A,B) show pre-operative postcontrast T1-weighted (A) and T2-weighted TSE MRI sequences, demonstrating ROI segmentation of lesion and peritumor edema, circumferentially outlined, using Horos software. (C,D) display postcontrast T1-weighted and T2-weighted TSE MRI sequences after surgical resection.