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

Background: Seizures in the early postoperative period may impair patient recovery and increase the risk of complications. 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 con...

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Autores principales: Batista, Sávio, Bertani, Raphael, Palavani, Lucca B., de Barros Oliveira, Leonardo, Borges, Pedro, Koester, Stefan W., Paiva, Wellingson Silva
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10670536/
https://www.ncbi.nlm.nih.gov/pubmed/37998550
http://dx.doi.org/10.3390/diagnostics13223415
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author Batista, Sávio
Bertani, Raphael
Palavani, Lucca B.
de Barros Oliveira, Leonardo
Borges, Pedro
Koester, Stefan W.
Paiva, Wellingson Silva
author_facet Batista, Sávio
Bertani, Raphael
Palavani, Lucca B.
de Barros Oliveira, Leonardo
Borges, Pedro
Koester, Stefan W.
Paiva, Wellingson Silva
author_sort Batista, Sávio
collection PubMed
description Background: Seizures in the early postoperative period may impair patient recovery and increase the risk of complications. 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 nine studies, a total of 3249 patients were evaluated, of which 984 patients received antiepileptic drugs (AEDs). No significant difference was observed in the frequency of seizure events between patients who were treated with antiepileptic drugs (AEDs) and those who were not. (RR 1.22, 95% CI 0.66 to 2.40; I(2) = 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 between the studies (I(2) = 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. Conclusions: 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.
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spelling pubmed-106705362023-11-09 Postoperative Seizure Prophylaxis in Meningioma Resection: A Systematic Review and Meta-Analysis Batista, Sávio Bertani, Raphael Palavani, Lucca B. de Barros Oliveira, Leonardo Borges, Pedro Koester, Stefan W. Paiva, Wellingson Silva Diagnostics (Basel) Systematic Review Background: Seizures in the early postoperative period may impair patient recovery and increase the risk of complications. 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 nine studies, a total of 3249 patients were evaluated, of which 984 patients received antiepileptic drugs (AEDs). No significant difference was observed in the frequency of seizure events between patients who were treated with antiepileptic drugs (AEDs) and those who were not. (RR 1.22, 95% CI 0.66 to 2.40; I(2) = 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 between the studies (I(2) = 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. Conclusions: 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. MDPI 2023-11-09 /pmc/articles/PMC10670536/ /pubmed/37998550 http://dx.doi.org/10.3390/diagnostics13223415 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Batista, Sávio
Bertani, Raphael
Palavani, Lucca B.
de Barros Oliveira, Leonardo
Borges, Pedro
Koester, Stefan W.
Paiva, Wellingson Silva
Postoperative Seizure Prophylaxis in Meningioma Resection: A Systematic Review and Meta-Analysis
title Postoperative Seizure Prophylaxis in Meningioma Resection: A Systematic Review and Meta-Analysis
title_full Postoperative Seizure Prophylaxis in Meningioma Resection: A Systematic Review and Meta-Analysis
title_fullStr Postoperative Seizure Prophylaxis in Meningioma Resection: A Systematic Review and Meta-Analysis
title_full_unstemmed Postoperative Seizure Prophylaxis in Meningioma Resection: A Systematic Review and Meta-Analysis
title_short Postoperative Seizure Prophylaxis in Meningioma Resection: A Systematic Review and Meta-Analysis
title_sort postoperative seizure prophylaxis in meningioma resection: a systematic review and meta-analysis
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10670536/
https://www.ncbi.nlm.nih.gov/pubmed/37998550
http://dx.doi.org/10.3390/diagnostics13223415
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