Objective: Seizures represent a common manifestation of intracranial meningiomas. Their predictive
factors before and after excision merit studying. Materials and Methods: Patients having intracranial meningioma were prospectively studied. There were two
groups; Group “A” with seizures and Group “B” with no preoperative epilepsy. Results: This study included 40 patients. Their ages ranged from 40 to 60 years old, and female-to-male
ratio was 2.3:1 in both groups. In Group A, partial seizures were the most common
pattern (60%). Manifestations other than fits included headache in most patients (97.5%),
symptoms of increased intracranial pressure were found in 50% in Group A and 20% in
Group B patients, peritumoral edema was present in 14 (70%) patients of Group A, compared
to 6 (25%) patients of Group “B.” There was a statistically significant relation between
peritumoral edema and presentation with fits (P < 0.1). Complication after surgery
included nonsurgical hematoma in three patients and contusion in 7 patients. Following
surgery for Group “A”, 8 (40%) patients had good seizure control. While, in Group
“B” 3 (15%), patients developed new-onset seizures. Good seizure control in 7 (53%)
patients with frontal, frontotemporal tumors than in other locations. In addition,
better control was obtained in left sided, small tumors, and no peritumoral edema.
Postoperative complication was significantly associated with new-onset epilepsy and
poor seizure control (P < 0.05). Neither tumor size nor location had a significant
relation to either pre or postoperative epilepsy. Conclusion: Predictive factors for epilepsy accompanying intracranial meningioma included males,
elderly patients and patients with small lesions, frontal and left-sided locations
but were statistically insignificant predictors. Peritumoral edema and postoperative
complications are the most significant predictors.
Key-words:
Epilepsy - excision - lesion - meningioma - peritumoral edema - seizure
