Risk Factors For Epilepsy Associated With Meningioma

Background and ObjectiveEpilepsy is a clinical syndrome caused by highly synchronous abnormal discharge of brain neurons.According to the latest epidemiological data in China,the overall prevalence of epilepsy in China is 7.0%,with an annual incidence of 28.8 per 100,000,and the prevalence of active epilepsy with seizures within one year is 4.6‰.According to this estimate,China has about 9 million epilepsy patients.Meningioma is originated from arachnoid endothelial cells of primary central nervous system tumors,which is the most common benign intracranial tumor,surgical resection is the treatment of meningioma in the conventional treatment,compared with other central nervous system tumors,patients with benign meningiomas 10-year survival rate is 80%,so people generally high treatment requirements of meningiomas,and people in meningioma treatment for postoperative patients quality of life also have higher requirements.However,the causes of seizures in meningioma growth and treatment have not been fully studied,and the risk factors for meningioma with epilepsy have not been concluded in the current studies.As a heterogeneous disease,epilepsy can affect the Quality of life in many aspects.Qol),so a better understanding and understanding of these complex risk factors and their importance in meningiomas can help in clinical decision-making and improve the quality of life of these patients,with the purpose of preventing epilepsy.In this study,the risk factors of meningioma associated with epilepsy were studied based on the data of patients with meningioma treated by neurosurgery in the Second Afiliated Hospital of Zhengzhou University.Materials and methodsWe collected 220 patients who underwent intracranial meningioma resection in the Second Affiliated Hospital of Zhengzhou University from January 2013 to December 2018.All the postoperative pathological findings were obtained by the World Health Organization.WHO)defined meningioma,detailed history after admission,clear whether a history of epilepsy,patients with epilepsy after admission preoperative unified line 24 hours Video eeg(Video Electroencephalogram,VEEG),diagnosed with epilepsy patients with preoperative oral valproic acid magnesium zyban,intraoperative resection at the same time,to be among them,100 cases of patients intraoperative cortical eeg monitoring(Electrocorticography;ECoG)ECoG monitored and treated epileptogenic foci,followed up for 3-12 months after operation(4 cases lost to follow-up).All relevant data and clinical data were statistically processed by SPSS version 21.0.Measurement data using t test,counting data by chi-square test,C value through the calculation of chi-square(contact number),observe the age,sex,tumor pathologic stage,tumor location,tumor size,if there is a tumor weeks edema,whether the tumor is aggressive,preoperative and postoperative prophylactic use of antiepileptic drugs,whether preoperative history of headache and the relevance of the preoperative epilepsy.In addition to preoperative have preoperative epilepsy and grade of tumor resection,whether intraoperative ECoG monitoring into the related factors and the related degree of postoperative secondary epilepsy to pay observation,with P<0.05 for the difference was statistically significant,and their selection of P<0.05 multiariable Logistic regression analysis of related factors,respectively analyzing the effects of related factors on preoperative and postoperative epilepsy occurs,with P<0.05 forjudging meningioma specific risk factors related to epilepsy have statistical significance.Results1.Patients with meningioma had epilepsy before surgery.1.1 There were 41 cases of meningioma with epilepsy before surgery,with an incidence of about 19.0%.1.2 According to the statistical analysis of univariate variables,gender(P=0.034),PTBE(P=0.043),tumor diameter(P=0.032),tumor location(P=0.014),tumor invasivity(P=0.030),and pathological grade of meningioma(P=0.002)were correlated with preoperative epilepsy in meningioma patients.Besides,according to the C value,we arranged in ascending order:peritumor Edema(periumoral Brain Edema;PTBE)(0.138),sex(0.144),tumor diameter(0.146),tumor invasiveness(0.148),tumor location(0.167),and pathological grade(0.216).The successively higher values indicated that the correlation between the variables and the occurrence of epilepsy before surgery was enhanced successively.However,P>0.05 was not statistically significant for age,preoperative headache and preoperative prophylactics.1.3 The results of multivariate logistic regression analysis showed that tumor diameter,tumor location and PTBE were independent risk factors(P<The pathological grade of meningioma was a protective factor.With meningioma pathological grade of the WHO ?/? grade,tumor diameter 3 cm or more,PTBE oedema diameter 1 cm or more,around the tumor is in the frontal and parietal,especially close to the central area of meningioma more easily in the preoperative symptoms in patients with epilepsy.Patients with meningioma had epilepsy after surgery2.1 Postoperative epilepsy occurred in 20 patients with meningioma,with an incidence of 9.3%.2.2 According to the statistical analysis of univariate variables,tumor pathological grade(P=0.015),tumor location(P=0.036),tumor diameter(P=0.039),tumor aggressiveness(P=0.020),tumor resection grade(P=0.043),preoperative history of epilepsy(P=0.027),and intraoperative ECoG monitoring(P=0.020)were correlated with postoperative epilepsy of meningioma patients.Ascending order according to the C value:tumor diameter(0.140),(0.143),tumor invasive tumor position(0.158),tumor resection grade(0.170),preoperative history of epilepsy(0.171),intraoperative ECoG monitoring(0.171),meningioma pathological grade(0.197),C value increased shows that the correlation with postoperative secondary epilepsy variables increase in turn.However,P>0.05 was not significantly different in age(P=0.676),gender(P=0.446),peritumor edema(0.133),preoperative prophylactic epileptic drug use(P=0.613),and postoperative prophylactic epileptic drug use(P=0.191).2.3 The results of multivariate logistic regression analysis showed that preoperative history of epilepsy,tumor invasion and tumor diameter were the risk factors for postoperative epilepsy in meningioma patients,and the statistical correlation was successively increased,and intraoperative ECoG monitoring was the protective factor.The incidence of postoperative epilepsy was lower in patients with preoperative history of epilepsy,invasive tumor,tumor diameter?3 cm,intraoperative ECoG monitoring and resection of epileptic foci than in patients without monitoring.Conclusion1.The incidence of epilepsy before meningioma was 19.0%,and the incidence of early postoperative epilepsy in meningioma patients was about 9.3%.2.Four major factors,including PTBE,tumor diameter,tumor location,and pathological grade of meningioma,were risk factors for preoperative epilepsy in patients with meningioma,and the statistical correlation increased successively(P?0.05).Tumor diameter,tumor invasion,intraoperative ECoG monitoring,and preoperative history of epilepsy were risk factors for postoperative epilepsy in meningioma patients,and their statistical correlations were enhanced successively(P?0.05).3.Intraoperative ECoG monitoring and resection of epileptic lesions can effectively reduce postoperative epileptic symptoms.