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Predictive factors for post operative seizures following meningioma resection in patients without preoperative seizures: a multicenter retrospective analysis

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Abstract

Purpose

Meningiomas are the most common primary brain tumor and represent 35% of all intracranial neoplasms. However, in the early post-operative period approximate 3–5% of patients experience an acute symptomatic seizure. Establishing risk factors for postoperative seizures will identify those patients without preoperative seizures at greatest risk of postoperative seizures and may guide antiseizure medications (ASMs) management.

Methods

Adult seizure naïve patients who underwent primary resection of a World Health Organization (WHO) Grade 1–3 meningioma at the three Mayo Clinic Campuses between 2012–2022 were retrospectively reviewed. Multivariate regression analyses were used to identify radiological, surgical, and management features with the development of new-onset seizures in patients undergoing meningioma resection.

Results

Of 113 seizure naïve patients undergoing meningioma resection 11 (9.7%) experienced a new-onset post-operative seizure. Tumor volume ≥ 25 cm3 (Odds Ratio (OR) 5.223, 95% Confidence Interval (CI) 1.546 – 17.650, p = 0.008) and cerebral convexity meningiomas (OR 4.742, 95% CI 1.255 – 14.336, p = 0.016) were most associated with new onset postoperative seizures in multivariate analysis. ASMs and corticosteroid therapies did not display a significant difference among those with and without a new onset postoperative seizure.

Conclusion

In the current study, a larger tumor volume (≥ 25 cm3) and/or convexity meningiomas predicted the development of new onset post-operative seizures. Those who present with these factors should be counseled for their increased risk of new onset post-operative seizures and may benefit from prophylactic ASMs therapy.

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Data availability

The data that support the findings of this study are available from the corresponding author, CM, upon reasonable request.

Abbreviations

ASMs:

Antiseizure medications

BBB:

Blood-brain-barrier

CI:

Confidence interval

EOR:

Extent of resection

GTR:

Gross total resection

IQR:

Interquartile Range

KPS:

Karnofsky Performance Scale

MRI:

Magnetic resonance imaging

OR:

Odds ratio

SVA2:

Synaptic vesicle glycoprotein 2

WHO:

World Health Organization

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Authors and Affiliations

  1. Department of Neurological Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA

    Chase McKevitt, Lina Marenco-Hillembrand, Michael Bamimore, Rosemary Chandler, Andrea Otamendi-Lopez, Joao Paulo Almeida, Alfredo Quiñones-Hinojosa & Kaisorn L. Chaichana

  2. Department of Neurological Surgery, Cooper University Health Care, 1 Cooper Plz, Camden, NJ, 08103, USA

    Michael Bamimore

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  1. Chase McKevitt
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Correspondence to Kaisorn L. Chaichana.

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McKevitt, C., Marenco-Hillembrand, L., Bamimore, M. et al. Predictive factors for post operative seizures following meningioma resection in patients without preoperative seizures: a multicenter retrospective analysis. Acta Neurochir 165, 1333–1343 (2023). https://doi.org/10.1007/s00701-023-05571-0

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