Meningiomas-Related Epilepsy After Surgery

Area of Science:

• Neurosurgery
• Epileptology
• Neuroradiology

Background:

• Meningioma-related epilepsy (MRE) affects approximately 30% of patients.
• Current research lacks clear guidelines on discontinuing antiseizure medications (ASMs) after surgical resection for MRE.

Purpose of the Study:

• To investigate the impact of surgical resection on MRE.
• To determine the role of peritumoral edema (PE) in MRE resolution and ASM discontinuation timing.

Main Methods:

• Retrospective analysis of 128 patients with supratentorial meningiomas who underwent surgical resection.
• Preoperative MRI used to quantify meningioma and peritumoral edema (PE) volumes.
• Analysis of epilepsy frequency pre- and post-surgery in relation to PE presence.

Main Results:

• Surgical treatment significantly reduced MRE from 41.4% to 19.5% (p=0.0001).
• Patients with preoperative PE showed a significant seizure reduction (45.3% to 18.9%, p=0.0002), unlike those without PE (p=0.24).
• ASM continuation was noted in 37.8% of Engel IA patients.

Conclusions:

• Peritumoral edema (PE) enhances the likelihood of MRE resolution following surgery.
• Surgical resection positively impacts MRE and ASM discontinuation, particularly when PE is present.
• PE serves as a key factor in guiding decisions about the timing of ASM discontinuation post-surgery.