Introduction: Seizures represent a common presentation of intracranial meningiomas occurring in 13–60 % of patients.
Methods: This prospective study includes 40 cases with intracranial meningioma admitted to the Neurosurgery Department, Alexandria University, between June and December 2014. We studied the impact of several factors on seizure occurrence following meningioma excision. Patients with recurrent or multiple meningiomas were excluded. All patients were followed up at least for one year.
Results: Patients were classified into 2 groups; Group “A” (20 patients) with history of preoperative seizures and Group “B” (20 patients) with no preoperative epilepsy. Three patients (15%) from the later group developed new onset seizures after surgery, where as 12 patients (60%) from group A developed at least a single seizure post-operatively. Partial seizure with secondary generalization was the most common epilepsy pattern.
The mean age was 50.65 years in group A, and 47.15 years in group B. The female to male ratio was 2.3:1 in both groups. There was a higher incidence of presentation with manifestations of increased intracranial pressure in group A; however, no statistically significant relation was found between the age, gender, clinical presentation, tumor site, side and size and the occurrence of seizures.
Peritumoral edema was present in 14 (70%) patients of group A, compared to 6 (25%) patients of group “B”. There was a statistically significant relation between peritumoral edema and seizure occurrence. Meningiothelial meningioma was the most common histopathological type in this series. There was no statistically significant relation between the different histopathological types and occurrence of epilepsy. The presence of postoperative contusions or hematomas was found to be significantly associated with postoperative epilepsy.
Conclusions: Meningioma excision has fair effect on seizure control. The presence of Peritumoral edema pre-operatively and the occurrence of postoperative complications are important predictive factor for seizure occurrence and control after excision.
Patient Care: It will improve the rates of controlled epilepsy after meningioma excision.
Learning Objectives: highlight clinical and radiological factors predicting seizure occurrence after meningioma excision.
define factors associated with poor epilepsy control after surgery