Risk Factors for the Development of De Novo Generalized Tonic-Clonic Epileptic Seizures in Patients with Supratentorial Meningiomas after Neurosurgical Treatment

Objectives. To identify risk factors for the occurrence of de novo epileptic seizures in the early postoperative period in patients with supratentorial meningiomas. Materials and methods. A retrospective 3:1 case-control study was conducted. A total of 248 case histories of patients with supratentorial meningioma who underwent surgical resection of tumors from January 1, 2017 to December 31, 2020 in the Department of Neurosurgery, Sklifosovskii Research Institute of Emergency Medicine were reviewed. Of 133 patients without epileptic seizures and a history of use of antiepileptic drugs before surgery, 10% (n = 14) had de novo generalized tonic-clonic seizures in the early postoperative period. Among the remaining 119 patients, 42 were selected to form a control group similar in age and tumor location and volume to the patients of the study group. All patients were assessed to evaluate their clinical condition, preoperative and postoperative contrast-enhanced neuroimaging results, and the course of the intraoperative period, as well as the duration and outcomes of hospitalization. Conclusions. Risk factors for the development of de novo seizures were an increase in the volume of cerebral edema over preoperative baseline on postoperative CT and the development of hemorrhagic transformation of cerebral edema. A prospective study is needed to determine risk factors for de novo seizures and to define prophylactic treatment.