EPILEPSIJA KOD PACIJENATA SA SUPRATENTORIJALNIM MENINGEOMIMA

Ivan Bogdanovic; Danica Grujičić; Aleksandar Ristić

doi:10.5937/mp74-43084

Ivan Bogdanovic Neurosurgeon
Danica Grujičić Prof.dr Danica Grujičić, neurohirurg Klinički Centar Srbije, Klinika za neurohirurgiju
Aleksandar Ristić Doc.dr Aleksandar Ristić, neurolog Klinički Centar Srbije, Klinika za neurologiju

DOI: https://doi.org/10.5937/mp74-43084

Ključne reči: epilepsija, meningeom, tumor, prediktori, hirurgija

Sažetak

Meningeomi su najčešći primarni intrakranijalni tumori. Uglavnom su spororastući i histopatološki su benigni što ih čini izlečivim samom hirurgijom. Simptomi i znaci koje izazivaju zavise od lokalizacije tumora i mogu se ispoljiti kao fokalni neurološki deficiti ili povišenim intrakranijalnim pritiskom. Epileptički napadi su kao inicijalni simptom prisutni kod približno 30% pacijenata sa supratentorijalnim meningeomima. Epileptogeneza kod ovih pacijenata još uvek nije u potpunosti objašnjena. Sama epilepsija negativno utiče na kvalitet života, ograničava samostalnost, ometa kogniciju i povećava rizik za psihijatrijske komorbiditete uključujući depresiju. Iako hirurška resekcija dovodi do oslobađanja pacijenata od napada u preko 60% slučajeva, kod značajnog broja pacijenata napadi su i dalje prisutni postoperativno. Potencijalni preoperativni i postoperativni prediktori za pojavu epilepsije kod pacijenata sa meningeomima su analizirani u više studija. Antikonvulzivni lekovi se primenjuju u lečenju ovih pacijenata, ali njihovo korišćenje je često praćeno neželjenim neurokognitivnim dejstvima i nisu efikasni kod svih pacijenata. Razumevanje različitih kliničkih, histopatoloških i hirurških faktora koji su potencijalno povezani sa pojavom epilepsije bi doprinelo boljoj kontroli napada i omogućilo bolju procenu rizika pre i posle same hirurgije. Pacijenti sa refraktornom epilepsijom bi mogli imati koristi od evaluacije u referentnom centru za epilepsije.

Reference

1. Wiemels, J., M. Wrensch, and E.B. Claus, Epidemiology and etiology of meningioma. J Neurooncol, 2010. 99(3): p. 307-14.

2. Erturk Cetin, O., et al., Epilepsy-related brain tumors. Seizure, 2017. 44: p. 93-97.

3. Englot, D.J., et al., Seizures in supratentorial meningioma: a systematic review and meta-analysis. J Neurosurg, 2016. 124(6): p. 1552-61.

4. Chaichana, K.L., et al., Seizure control for patients undergoing meningioma surgery. World Neurosurg, 2013. 79(3-4): p. 515-24.

5. Tanti, M.J., et al., The impact of epilepsy on the quality of life of patients with meningioma: A systematic review. Br J Neurosurg, 2016. 30(1): p. 23-8.

6. Bauer, R., et al., Treatment of epileptic seizures in brain tumors: a critical review. Neurosurg Rev, 2014. 37(3): p. 381-8; discussion 388.

7. Baumgarten, P., et al., Focused review on seizures caused by meningiomas. Epilepsy Behav, 2018. 88: p. 146-151.

8. Cramer, J.A., et al., Adverse effects of antiepileptic drugs: a brief overview of important issues. Expert Rev Neurother, 2010. 10(6): p. 885-91.

9. Weller, R.O., et al., The meninges as barriers and facilitators for the movement of fluid, cells and pathogens related to the rodent and human CNS. Acta Neuropathol, 2018. 135(3): p. 363-385.

10. Chen, D.Y., et al., Tumor-related epilepsy: epidemiology, pathogenesis and management. J Neurooncol, 2018. 139(1): p. 13-21.

11. Fang, S., et al., Predictive value of electrocorticography for postoperative epilepsy in patients with supratentorial meningioma. J Clin Neurosci, 2013. 20(1): p. 112-6.

12. Hess, K., et al., Brain invasion and the risk of seizures in patients with meningioma. J Neurosurg, 2018. 130(3): p. 789-796.

13. Shamji, M.F., E.C. Fric-Shamji, and B.G. Benoit, Brain tumors and epilepsy: pathophysiology of peritumoral changes. Neurosurg Rev, 2009. 32(3): p. 275-84; discussion 284-6.

14. Islim, A.I., et al., The role of prophylactic antiepileptic drugs for seizure prophylaxis in meningioma surgery: A systematic review. J Clin Neurosci, 2017. 43: p. 47-53.

15. Lu, V.M., et al., Four Independent Predictors of Postoperative Seizures After Meningioma Surgery: A Meta-Analysis. World Neurosurg, 2019. 130: p. 537-545 e3.

16. Schutze, S., I.J. Orozco, and T.J. Jentsch, KCNQ Potassium Channels Modulate Sensitivity of Skin Down-hair (D-hair) Mechanoreceptors. J Biol Chem, 2016. 291(11): p. 5566-5575.

17. Ranade, S.S., R. Syeda, and A. Patapoutian, Mechanically Activated Ion Channels. Neuron, 2015. 87(6): p. 1162-1179.

18. Chen, W.C., et al., Factors Associated With Pre- and Postoperative Seizures in 1033 Patients Undergoing Supratentorial Meningioma Resection. Neurosurgery, 2017. 81(2): p. 297-306.

19. Lieu, A.S. and S.L. Howng, Intracranial meningiomas and epilepsy: incidence, prognosis and influencing factors. Epilepsy Res, 2000. 38(1): p. 45-52.

20. Islim, A.I., et al., Postoperative seizures in meningioma patients: improving patient selection for antiepileptic drug therapy. J Neurooncol, 2018. 140(1): p. 123-134.

21. Morsy, M.M., et al., Predictive Factors for Seizures Accompanying Intracranial Meningiomas. Asian J Neurosurg, 2019. 14(2): p. 403-409.

22. Wang, Y.C., et al., Seizures in surgically resected atypical and malignant meningiomas: Long-term outcome analysis. Epilepsy Res, 2018. 140: p. 82-89.

23. Li, X., et al., Risk factors and control of seizures in 778 Chinese patients undergoing initial resection of supratentorial meningiomas. Neurosurg Rev, 2020. 43(2): p. 597-608.

24. Xue, H., et al., Long-term control and predictors of seizures in intracranial meningioma surgery: a population-based study. Acta Neurochir (Wien), 2018. 160(3): p. 589-596.

25. Seyedi, J.F., C.B. Pedersen, and F.R. Poulsen, Risk of seizures before and after neurosurgical treatment of intracranial meningiomas. Clin Neurol Neurosurg, 2018. 165: p. 60-66.

26. Beghi, E., et al., Recommendation for a definition of acute symptomatic seizure. Epilepsia, 2010. 51(4): p. 671-5.

27. Baumgarten, P., et al., Early and Late Postoperative Seizures in Meningioma Patients and Prediction by a Recent Scoring System. Cancers (Basel), 2021. 13(3).

28. Wirsching, H.G., et al., Predicting outcome of epilepsy after meningioma resection. Neuro Oncol, 2016. 18(7): p. 1002-10.

29. Zheng, Z., et al., Early and late postoperative seizure outcome in 97 patients with supratentorial meningioma and preoperative seizures: a retrospective study. J Neurooncol, 2013. 114(1): p. 101-9.

30. Connolly, I.D., et al., Craniotomy for Resection of Meningioma: An Age-Stratified Analysis of the MarketScan Longitudinal Database. World Neurosurg, 2015. 84(6): p. 1864-70.

31. Raza, S.M., et al., Perioperative and long-term outcomes from the management of parasagittal meningiomas invading the superior sagittal sinus. Neurosurgery, 2010. 67(4): p. 885-93; discussion 893.

32. Hamasaki, T., et al., Higher incidence of epilepsy in meningiomas located on the premotor cortex: a voxel-wise statistical analysis. Acta Neurochir (Wien), 2012. 154(12): p. 2241-9.

33. Das, R.R., et al., Outcomes after discontinuation of antiepileptic drugs after surgery in patients with low grade brain tumors and meningiomas. J Neurooncol, 2012. 107(3): p. 565-70.

34. Komotar, R.J., et al., Prophylactic antiepileptic drug therapy in patients undergoing supratentorial meningioma resection: a systematic analysis of efficacy. J Neurosurg, 2011. 115(3): p. 483-90.

35. Walbert, T., et al., SNO and EANO practice guideline update: Anticonvulsant prophylaxis in patients with newly diagnosed brain tumors. Neuro Oncol, 2021. 23(11): p. 1835-1844.

36. Zhang, B., et al., Assessment of risk factors for early seizures following surgery for meningiomas using logistic regression analysis. J Int Med Res, 2011. 39(5): p. 1728-35.

37. Glantz, M.J., et al., Practice parameter: anticonvulsant prophylaxis in patients with newly diagnosed brain tumors. Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 2000. 54(10): p. 1886-93.

38. van der Meer, P.B., et al., Prescription preferences of antiepileptic drugs in brain tumor patients: An international survey among EANO members. Neurooncol Pract, 2022. 9(2): p. 105-113.