EPILEPSIJA KOD PACIJENATA SA SUPRATENTORIJALNIM MENINGEOMIMA

  • 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
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. 

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2024/02/22
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