文章：

术后脑膜瘤相关性癫痫

Meningiomas-Related Epilepsy After Surgery

原文发布日期：30 April 2025

DOI: 10.3390/cancers17091523

类型: Article

开放获取: 是

英文摘要：

Background: Meningioma-related epilepsy (MRE) is observed in approximately 30% of patients. Although studies focus on identifying risk factors related to pre- and postoperative MRE, there is no clear evidence regarding the timing for discontinuing antiseizure medications (ASMs) after surgical resection. Methods: We retrospectively collected data from a series of naïve supratentorial meningiomas treated with surgical resection. Preoperative MRI was used to calculate the meningioma and peritumoral edema (PE) volumes through a voxel-based system. We analyzed the frequency of pre- and postoperative epilepsy in the group of meningiomas with and without perilesional edema (with PE > 1 cm3as the cut-off). Results: From a clinical series of 507 patients, we included 128 who underwent surgical resection in our center between January 2020 and December 2022, with a mean follow-up of 30.1 ± 19.8 months. Surgical treatment had a curative effect on MRE (41.4% preoperative vs. 19.5% postoperative;p= 0.0001). We observed a statistically significant reduction in the seizure rate in cases with preoperative PE (45.3% preoperative vs. 18.9% postoperative;p= 0.0002) and a non-statistically significant reduction in cases without PE (32.5% preoperative vs. 21.4% postoperative;p= 0.24). We observed ASM continuation in 37.8% of Engel IA patients. Conclusions: PE increases the likelihood of MRE resolution with surgery. Our results show that surgical resection directly impacts MRE and ASM discontinuation in the presence of preoperative PE. The PE is a reassuring factor in decision-making regarding the timing of ASM discontinuation after surgery.

摘要翻译： 

背景：脑膜瘤相关性癫痫（MRE）在约30%的患者中可见。尽管现有研究致力于识别与术前及术后MRE相关的风险因素，但关于手术切除后抗癫痫药物（ASMs）停药时机尚无明确证据。方法：我们回顾性收集了一系列经手术切除治疗的原发性幕上脑膜瘤病例数据。通过基于体素的系统，利用术前MRI计算脑膜瘤及瘤周水肿（PE）体积。我们以瘤周水肿体积大于1 cm³为界值，对比分析伴有与不伴有瘤周水肿的脑膜瘤组别中术前及术后癫痫的发生频率。结果：从507例临床病例系列中，我们纳入了2020年1月至2022年12月期间在本中心接受手术切除的128例患者，平均随访时间为30.1 ± 19.8个月。手术治疗对MRE具有显著疗效（术前发生率41.4% vs. 术后19.5%；p=0.0001）。我们观察到术前存在PE的病例其癫痫发生率具有统计学显著下降（术前45.3% vs. 术后18.9%；p=0.0002），而无PE的病例下降趋势无统计学意义（术前32.5% vs. 术后21.4%；p=0.24）。在Engel IA分级患者中，我们观察到37.8%的患者继续使用ASMs。结论：PE的存在提高了手术治愈MRE的可能性。我们的研究结果表明，在术前存在PE的情况下，手术切除直接影响MRE的转归及ASMs的停用。PE可作为术后决定ASMs停药时机的重要参考因素。

原文链接：

Meningiomas-Related Epilepsy After Surgery