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- Title
Long-term antiseizure medication use in patients after meningioma resection: identifying predictors for successful weaning and failures.
- Authors
Ellis, Erin M.; Drumm, Michael R.; Rai, Samhitha M.; Huang, Jonathan; Tate, Matthew C.; Magill, Stephen T.; Templer, Jessica W.
- Abstract
Objective: To define risk factors for meningioma-related seizures and predictors of successful weaning of antiseizure medications following meningioma resection. Methods: This is a retrospective study of 95 patients who underwent meningioma resection at a single institution. Primary outcome analyzed was ability to achieve seizure freedom without the use of anti-seizure medication at 6-months, 1-year, and last known follow up. Secondary outcome was postoperative seizure freedom. Results: Preoperative seizures (OR: 11.63, 95% CI [3.64, 37.17], p < 0.0001), non-skull base tumor location (OR: 3.01, 95% CI [1.29, 7.02], p = 0.0128), and modified STAMPE score of 3–5 (OR: 5.42, 95% CI [2.18, 13.52], p = 0.0003) were associated with greater likelihood of remaining on antiseizure medication at 6-month follow up. Preoperative seizures (OR: 4.93, 95% CI: [2.00, 12.16 ], p = 0.0008), intratumoral calcifications (OR: 4.19, 95% CI: [1.61, 14.46], p = 0.0055), modified STAMPE score of 3–5 (OR: 5.42, CI [2.18, 13.52], p = 0.0003), and Ki67 greater than 7% (OR: 5.68, CI [1.61, 20.10], p = 0.0060) were significant risk factors for inability to discontinue ASMs by last follow up. Preoperative seizures (OR: 4.33, 95% CI [1.59, 11.85], p = 0.0050) and modified STAMPE score of 3–5 (OR: 6.09, 95% CI [2.16, 17.20], p = 0.0007) were significant risk factors for postoperative seizures. Conclusions: Preoperative seizures, modified STAMPE2 score of 3–5, non-skull base tumor location, intratumoral calcifications, and Ki67 > 7% were significant risk factors for inability to achieve seizure freedom without ASMs. In addition, the modified STAMPE2 score successfully predicted increased seizure risk following meningioma resection for patients with a score of 3 or higher.
- Subjects
MENINGIOMA; NONINVASIVE ventilation; EPILEPSY; PREOPERATIVE risk factors; DRUGS; ANTICONVULSANTS
- Publication
Journal of Neuro-Oncology, 2023, Vol 165, Issue 1, p201
- ISSN
0167-594X
- Publication type
Article
- DOI
10.1007/s11060-023-04481-6