title: Risk Factors of Preoperative and Early Postoperative Seizures in Patients with Meningioma: A Retrospective Single-Center Cohort Study.
abstract: OBJECTIVE
  Well-defined risk factors for the identification of patients with meningioma who might benefit from preoperative or early postoperative seizure prophylaxis are unknown. We investigated and quantified risk factors to determine individual risks of seizure occurrence in patients with meningioma.
  
  
  METHODS
  A total of 634 adult patients with meningioma were included in this retrospective cohort study. Patient gender and age, tumor location, grade and volume, usage of antiepileptic drugs (AEDs) and extent of resection were determined.
  
  
  RESULTS
  Preoperative and early postoperative seizures occurred in 15% (n = 97) and 5% (n = 21) of the patients, respectively. Overall, 502 and 418 patients were eligible for multivariate logistic regression analyses of preoperative and early postoperative seizures, respectively. Male gender (odds ratio [OR], 2.06; P = 0.009), a non-skull base location (OR, 4.43; P < 0.001), and a tumor volume of >8 cm3(OR, 3.05; P = 0.002) were associated with a higher risk of preoperative seizures and were used to stratify the patients into 3 prognostic groups. The high-risk subgroup of patients with meningioma showed a seizure rate of >40% (OR, 9.8; P < 0.001). Only a non-skull base tumor location (OR, 2.61; P = 0.046) was identified as a significant risk factor for early postoperative seizures. AEDs did not reduce early postoperative seizure occurrence.
  
  
  CONCLUSIONS
  Seizure prophylaxis might be considered for patients at high risk of developing seizures who are for other reasons being considered for watchful waiting instead of resection. In contrast, our data do not provide any evidence of the efficacy of perioperative AEDs in patients with meningioma.
authors: Department of Neurosurgery, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany; Neuro-Oncology Center, Comprehensive Cancer Center Tübingen, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany. Electronic address: marco.skardelly@med.uni-tuebingen.de.
authors: Marco
authors: M
authors: Skardelly
authors: Department of Neurosurgery, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany; Neuro-Oncology Center, Comprehensive Cancer Center Tübingen, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany.
authors: Christian
authors: C
authors: Rother
authors: Department of Neurosurgery, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany; Neuro-Oncology Center, Comprehensive Cancer Center Tübingen, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany.
authors: Susan
authors: S
authors: Noell
authors: Department of Neurosurgery, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany; Neuro-Oncology Center, Comprehensive Cancer Center Tübingen, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany.
authors: Felix
authors: F
authors: Behling
authors: Department of Neurosurgery, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany; Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany; Neuro-Oncology Center, Comprehensive Cancer Center Tübingen, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany.
authors: Thomas V
authors: TV
authors: Wuttke
authors: Institute of Pathology and Neuropathology, Division of Neuropathology, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany; Neuro-Oncology Center, Comprehensive Cancer Center Tübingen, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany.
authors: Jens
authors: J
authors: Schittenhelm
authors: Department of Neuroradiology, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany; Neuro-Oncology Center, Comprehensive Cancer Center Tübingen, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany.
authors: Sotirios
authors: S
authors: Bisdas
authors: Institute of Clinical Epidemiology and Applied Biometry, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany.
authors: Christoph
authors: C
authors: Meisner
authors: Department of Neurosurgery, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany.
authors: Sabine
authors: S
authors: Rona
authors: Department of Neurosurgery, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany; Interdisciplinary Division of Neuro-Oncology, Departments of Vascular Neurology and Neurosurgery, Hertie Institute for Clinical Brain Research, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany; Neuro-Oncology Center, Comprehensive Cancer Center Tübingen, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany; German Cancer Consortium (DKTK), DKFZ partner site Tübingen, Tübingen, Germany; Center for Personalized Medicine, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany.
authors: Ghazaleh
authors: G
authors: Tabatabai
authors: Department of Neurosurgery, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany.
authors: Florian
authors: F
authors: Roser
authors: Department of Neurosurgery, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany; Neuro-Oncology Center, Comprehensive Cancer Center Tübingen, Eberhard Karls University of Tübingen, University Hospital Tübingen, Tübingen, Germany.
authors: Marcos Soares
authors: MS
authors: Tatagiba
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008577:Meningeal Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D008579:Meningioma / Q000453:epidemiology* / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D057234:Preoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D012640:Seizures / Q000453:epidemiology* / Q000517:prevention & control; D017678:Sex Distribution; D016896:Treatment Outcome; D055815:Young Adult
keywords: Antiepileptic drugs; Effect size; Epilepsy; Meningioma; Risk factor; Seizure