REVIEW
Introdução: Meningioma é um tumor primário do sistema nervoso central, cuja origem se dá nas células meningoepiteliais da aracnoide. A relação entre epilepsia e tumores cerebrais foi descrita pela primeira vez em 1984, por Jakson. Já no caso do meningioma, a presença de convulsões foi relatada em um terço dos pacientes e há estudos que apontam maior incidência de convulsões em casos de meningioma do que glioblastoma primário e metástases cerebrais. O tratamento de escolha para a epilepsia nestes casos é a ressecção cirúrgica. Métodos: O estudo é uma revisão sistemática, com dados derivados de artigos da base de dados PubMed. O recorte temporal da pesquisa foi de 1965 até 2023. Os artigos selecionados para o estudo foram aqueles que tinham relação com casos de epilepsia ou convulsões em pacientes com meningioma. A exclusão de estudos foi a partir da não relação entre os descritores, a falta de DOI e a ausência de dados quantificados em número de incidência das convulsões, assim como a não disponibilização de artigo completo. 20 artigos foram selecionados para a revisão atual. Resultados: A incidência de convulsões pré-operatórias em pacientes com meningioma é de aproximadamente 25,90% e a taxa de pacientes pós-operatórios que cessaram as convulsões é de 63 a 64%. Entre os fatores de risco identificados nos estudos, existem fatores comuns, como a ausência de cefaleia, tumores não base de crânio, sexo masculino, a área de edema peritumoral, principalmente em edemas maiores que ≥ 1 cm, e tumores localizados em regiões de convexidade ou parassagitais, tal como graus II e III na classificação OMS. Conclusão: Esta revisão sistemática fornece insights na incidência de convulsões em pacientes com meningioma, destacando as taxas pré e pós-operatórias e identificando fatores de risco associados. A compreensão desses fatores pode orientar os clínicos no manejo e tratamento da epilepsia associada ao meningioma.
Introduction: Meningioma is a primary tumor of the central nervous system originating from arachnoid meningoepithelial cells. In the case of meningioma, seizures have been reported in one-third of patients, with studies indicating a higher incidence of seizures in meningioma cases than in primary glioblastoma and brain metastases. The preferred treatment for epilepsy in these cases is surgical resection. Methods: This study is a systematic review based on articles from the PubMed database, in the period of 1965 to 2023. A total of 20 articles were selected for the current review. Results: The incidence of preoperative seizures in patients with meningioma is approximately 25.90%, with a postoperative seizure cessation rate of 63 to 64%. Common risk factors identified in the studies include the absence of headache, non-skull base tumors, male gender, peritumoral edema area, particularly in edema greater than or equal to 1 cm, tumors located in convexity or parasagittal regions, and WHO grades II and III. Conclusion: This systematic review provides insights into the incidence of seizures in patients with meningioma, highlighting preoperative and postoperative rates and identifying associated risk factors. Understanding these factors can guide clinicians in the management and treatment of meningioma-associated epilepsy.
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1MS, Universidade São Judas Tadeu - USJT; Internship in Neurosurgery, Hospital Santa Paula, São Paulo, SP, Brazil.
2MD, MR, Neurosurgery residency, Hospital Santa Paula, São Paulo, SP, Brazil.
3MD, PhD, Neurosurgeon, Coordinator of Residency Program at Hospital Santa Paula, Medicine Department at Pontifícia Universidade Católica de São Paulo, Sorocaba, SP, and Faculdade de
Medicina do ABC, Santo André, SP, Brazil.
Received Dec 16, 2023
Accepted Jan 3, 2024
