Antiseizure medication use after meningioma resection: A single institution experience

Erin Ellis,Michael R. Drumm, Samhitha Rai,Jonathan Huang,Matthew C. Tate, Stephen T. Magill, Jessica W. Templer

Research Square (Research Square)(2022)

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摘要
Abstract Objective: The objective of this study was to investigate the antiseizure medication (ASM) practice behavior at a single institution with regards to type, dosage, and frequency in patients who present with seizures prior to meningioma resection and to review post-operative ASM management. Methods: A retrospective study of 112 consecutive patients with meningiomas who underwent resection at a single institution between October 2016 and January 2020. Data was collected through detailed chart review, and included demographics, pre-and post-operative seizure characteristics, and type, dose, frequency, and changes to ASM regimens. Results:Thirty-five patients (31%) had a preoperative seizure, and 43 (38%) of patients were prescribed a preoperative ASM. At discharge, 96 (86%) of patients were prescribed an ASM, which was most often 1000 mg daily total of levetiracetam (64%, 61/96), and less often higher doses of levetiracetam or other ASMs. By the six-month postoperative visit, 55 (49%) of patients were taking at least one ASM, and this number of patients further decreased to 45 (40%) and 36 (32%) by one-year follow-up and last-known follow-up, respectively. Median time to last follow-up was 27.3 months (range = 5.4 – 57.4 months), and by last follow-up, 24 (21%) of patients had experienced a post-operative seizure, and 36 (32%) of patients were never able to discontinue their ASMs. Conclusions: Most patients who underwent surgical resection of their meningioma were eventually able to completely discontinue their postoperative ASM regimen. However, a large minority of patients continued to experience postoperative seizures throughout their treatment course and required long-term management.
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meningioma resection
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