PDF(Pubmed)
Abstract：
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; 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 between the studies (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.
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.
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; 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 between the studies (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.
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.
摘要：
背景：术后早期癫痫发作可能会损害患者的康复并增加并发症的风险。这项研究的目的是确定脑膜瘤切除术后预防癫痫发作是否有任何优势。
方法：本系统综述按照PRISMA指南进行。pubmed,WebofScience,Embase,科学直接，直到2023年4月，科克伦一直在寻找论文。
结果：在九项研究中，对3249例患者进行了评估，其中984名患者接受了抗癫痫药物（AEDs）。在接受抗癫痫药物（AED）治疗的患者和未接受抗癫痫药物治疗的患者之间，癫痫发作事件的频率没有显着差异。（RR1.22，95%CI0.66至2.40；I2=57%）。术后癫痫发作发生在早期时间段（<7天）的5%（95%CI：1%至9%），在后期（>7天）为9%（95%CI：1%至17%），研究之间具有显著的异质性(I2=91%和97%，分别)。在首次发作的患者中，术后癫痫发作率在早期为2%(95%CI:0%~6%),在晚期增加至6%(95%CI:0%~15%).高度异质性导致在所有分析中都使用随机效应模型。
结论：目前的证据没有为预防性AED药物预防脑膜瘤切除术患者术后癫痫发作的有效性提供足够的支持。这强调了在这种情况下考虑诊断标准和进行个体患者分析以指导临床决策的重要性。
方法：本系统综述按照PRISMA指南进行。pubmed,WebofScience,Embase,科学直接，直到2023年4月，科克伦一直在寻找论文。
结果：在九项研究中，对3249例患者进行了评估，其中984名患者接受了抗癫痫药物（AEDs）。在接受抗癫痫药物（AED）治疗的患者和未接受抗癫痫药物治疗的患者之间，癫痫发作事件的频率没有显着差异。（RR1.22，95%CI0.66至2.40；I2=57%）。术后癫痫发作发生在早期时间段（<7天）的5%（95%CI：1%至9%），在后期（>7天）为9%（95%CI：1%至17%），研究之间具有显著的异质性(I2=91%和97%，分别)。在首次发作的患者中，术后癫痫发作率在早期为2%(95%CI:0%~6%),在晚期增加至6%(95%CI:0%~15%).高度异质性导致在所有分析中都使用随机效应模型。
结论：目前的证据没有为预防性AED药物预防脑膜瘤切除术患者术后癫痫发作的有效性提供足够的支持。这强调了在这种情况下考虑诊断标准和进行个体患者分析以指导临床决策的重要性。
