Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Postoperative Seizure Prophylaxis in Meningioma Resection: A Systematic Review and Meta-Analysis

Sávio Batista
* ,
Raphael Bertani
ORCID logo ,
Lucca B Palavani
ORCID logo ,
Leonardo de Barros Oliveira
ORCID logo ,
Pedro Borges
ORCID logo ,
Stefan W Koester
,
Wellingson Silva Paiva
ORCID logo
Version 1 : Received: 1 June 2023 / Approved: 28 June 2023 / Online: 28 June 2023 (10:57:21 CEST)

A peer-reviewed article of this Preprint also exists.

Batista, S.; Bertani, R.; Palavani, L.B.; de Barros Oliveira, L.; Borges, P.; Koester, S.W.; Paiva, W.S. Postoperative Seizure Prophylaxis in Meningioma Resection: A Systematic Review and Meta-Analysis. Diagnostics 2023, 13, 3415. Batista, S.; Bertani, R.; Palavani, L.B.; de Barros Oliveira, L.; Borges, P.; Koester, S.W.; Paiva, W.S. Postoperative Seizure Prophylaxis in Meningioma Resection: A Systematic Review and Meta-Analysis. Diagnostics 2023, 13, 3415.

Abstract

Background: Seizures in the early postoperative period may impair patient recovery and increase risk of complication. The aim of this study is to determine whether there is any advantage in postoperative seizure prophylaxis following meningioma resection. Methods: This systematic review was conducted in accordance with PRISMA guidelines. PUBMED, Web of Science, Embase, Science Direct, and Cochrane were searched for papers until April 2023. Results: Among 9 studies, a total of 3,249 were evaluated patients, of which 984 patients received antiepileptic drugs (AEDs). A comparison between patients who received AEDs and those who did not showed a non-significant differences between both groups (RR 1.22, 95% CI 0.66 to 2.40; I² = 57%). Postoperative seizures occurred in 5% (95% CI: 1% to 9%) within the early time period (<7 days), and 9% (95% CI: 1% to 17%) in the late time period (>7 days), with significant heterogeneity (I² = 91% and 97% respectively). In seizure-naive patients, the rate of postoperative seizures was 2% (95% CI: 0% to 6%) in the early period and increased to 6% (95% CI: 0% to 15%) in the late period. High heterogeneity led to the use of random-effects models in all analyses. Conclusion: The current evidence does not provide sufficient support for the effectiveness of prophylactic AED medications in preventing postoperative seizures in patients undergoing meningioma resection. This underscores the importance of considering diagnostic criteria and conducting individual patient analysis to guide clinical decision-making in this context.

Keywords

Meningioma; Seizure prophylaxis; Antiepileptic drugs

Subject

Medicine and Pharmacology, Neuroscience and Neurology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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