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      Early and Late Postoperative Seizures in Meningioma Patients and Prediction by a Recent Scoring System


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          Seizures are among the most common symptoms of meningioma patients even after surgery. This study sought to identify risk factors for early and late seizures in meningioma patients and to evaluate a modified version of a score to predict postoperative seizures on an independent cohort. The data underline that there are distinct factors identifying patients with a high risk of postoperative seizures following meningioma surgery which has been already shown before. We could further show that the high proportion of 43% of postoperative seizures occur as late seizures which are more dangerous because they may happen out of hospital. The modified STAMPE2 score could predict postoperative seizures when reaching very high scores but was not generally transferable to our independent cohort.


          Seizures are among the most common symptoms of meningioma. This retrospective study sought to identify risk factors for early and late seizures in meningioma patients and to evaluate a modified STAMPE2 score. In 556 patients who underwent meningioma surgery, we correlated different risk factors with the occurrence of postoperative seizures. A modified STAMPE2 score was applied. Risk factors for preoperative seizures were edema ( p = 0.039) and temporal location ( p = 0.038). For postoperative seizures preoperative tumor size ( p < 0.001), sensomotory deficit ( p = 0.004) and sphenoid wing location ( p = 0.032) were independent risk factors. In terms of postoperative status epilepticus; sphenoid wing location ( p = 0.022), tumor volume ( p = 0.045) and preoperative seizures ( p < 0.001) were independent risk factors. Postoperative seizures lead to a KPS deterioration and thus an impaired quality of life ( p < 0.001). Late seizures occurred in 43% of patients with postoperative seizures. The small sub-cohort of patients (2.7%) with a STAMPE2 score of more than six points had a significantly increased risk for seizures ( p < 0.001, total risk 70%). We concluded that besides distinct risk factors, high scores of the modified STAMPE2 score could estimate the risk of postoperative seizures. However, it seems not transferable to our cohort

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          The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary.

          The 2016 World Health Organization Classification of Tumors of the Central Nervous System is both a conceptual and practical advance over its 2007 predecessor. For the first time, the WHO classification of CNS tumors uses molecular parameters in addition to histology to define many tumor entities, thus formulating a concept for how CNS tumor diagnoses should be structured in the molecular era. As such, the 2016 CNS WHO presents major restructuring of the diffuse gliomas, medulloblastomas and other embryonal tumors, and incorporates new entities that are defined by both histology and molecular features, including glioblastoma, IDH-wildtype and glioblastoma, IDH-mutant; diffuse midline glioma, H3 K27M-mutant; RELA fusion-positive ependymoma; medulloblastoma, WNT-activated and medulloblastoma, SHH-activated; and embryonal tumour with multilayered rosettes, C19MC-altered. The 2016 edition has added newly recognized neoplasms, and has deleted some entities, variants and patterns that no longer have diagnostic and/or biological relevance. Other notable changes include the addition of brain invasion as a criterion for atypical meningioma and the introduction of a soft tissue-type grading system for the now combined entity of solitary fibrous tumor / hemangiopericytoma-a departure from the manner by which other CNS tumors are graded. Overall, it is hoped that the 2016 CNS WHO will facilitate clinical, experimental and epidemiological studies that will lead to improvements in the lives of patients with brain tumors.
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            The recurrence of intracranial meningiomas after surgical treatment.

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              A definition and classification of status epilepticus--Report of the ILAE Task Force on Classification of Status Epilepticus.

              The Commission on Classification and Terminology and the Commission on Epidemiology of the International League Against Epilepsy (ILAE) have charged a Task Force to revise concepts, definition, and classification of status epilepticus (SE). The proposed new definition of SE is as follows: Status epilepticus is a condition resulting either from the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms, which lead to abnormally, prolonged seizures (after time point t1 ). It is a condition, which can have long-term consequences (after time point t2 ), including neuronal death, neuronal injury, and alteration of neuronal networks, depending on the type and duration of seizures. This definition is conceptual, with two operational dimensions: the first is the length of the seizure and the time point (t1 ) beyond which the seizure should be regarded as "continuous seizure activity." The second time point (t2 ) is the time of ongoing seizure activity after which there is a risk of long-term consequences. In the case of convulsive (tonic-clonic) SE, both time points (t1 at 5 min and t2 at 30 min) are based on animal experiments and clinical research. This evidence is incomplete, and there is furthermore considerable variation, so these time points should be considered as the best estimates currently available. Data are not yet available for other forms of SE, but as knowledge and understanding increase, time points can be defined for specific forms of SE based on scientific evidence and incorporated into the definition, without changing the underlying concepts. A new diagnostic classification system of SE is proposed, which will provide a framework for clinical diagnosis, investigation, and therapeutic approaches for each patient. There are four axes: (1) semiology; (2) etiology; (3) electroencephalography (EEG) correlates; and (4) age. Axis 1 (semiology) lists different forms of SE divided into those with prominent motor systems, those without prominent motor systems, and currently indeterminate conditions (such as acute confusional states with epileptiform EEG patterns). Axis 2 (etiology) is divided into subcategories of known and unknown causes. Axis 3 (EEG correlates) adopts the latest recommendations by consensus panels to use the following descriptors for the EEG: name of pattern, morphology, location, time-related features, modulation, and effect of intervention. Finally, axis 4 divides age groups into neonatal, infancy, childhood, adolescent and adulthood, and elderly.

                Author and article information

                Role: Academic Editor
                Cancers (Basel)
                Cancers (Basel)
                25 January 2021
                February 2021
                : 13
                : 3
                : 450
                [1 ]Department of Neurosurgery, University Hospital, Goethe University Frankfurt, 60528 Frankfurt am Main, Germany; mana-s@ 123456hotmail.de (M.S.); daniel.monden96@ 123456googlemail.com (D.M.); andrea.spyrantis@ 123456kgu.de (A.S.); florian.gessler@ 123456kgu.de (F.G.); daniel.dubinski@ 123456kgu.de (D.D.); gerhard.marquardt@ 123456kgu.de (G.M.); v.seifert@ 123456em.uni-frankfurt.de (V.S.); Thomas.Freiman@ 123456med.uni-rostock.de (T.M.F.)
                [2 ]Neurological Institute (Edinger Institute), University Hospital, Goethe University Frankfurt, 60528 Frankfurt am Main, Germany; simon.bernatz@ 123456kgu.de (S.B.); patrick.harter@ 123456kgu.de (P.N.H.)
                [3 ]Department of Neuroradiology, University Hospital, Goethe University Frankfurt, 60528 Frankfurt am Main, Germany; elke.hattingen@ 123456kgu.de
                [4 ]Epilepsy Center Frankfurt Rhine-Main, University Hospital, Goethe University Frankfurt, 60528 Frankfurt am Main, Germany; strzelczyk@ 123456med.uni-frankfurt.de (A.S.); felix.rosenow@ 123456kgu.de (F.R.)
                [5 ]Department of Neurology, University Hospital, Goethe University Frankfurt, 60528 Frankfurt am Main, Germany
                [6 ]LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, 60528 Frankfurt am Main, Germany
                [7 ]German Cancer Consortium (DKTK) Partner Site Frankfurt/Mainz, 60528 Frankfurt am Main, Germany
                [8 ]German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
                [9 ]Frankfurt Cancer Institute (FCI), 60528 Frankfurt am Main, Germany
                Author notes
                [* ]Correspondence: peter.baumgarten2@ 123456kgu.de ; Tel.: +49-(0)69-6301-5295
                Author information
                © 2021 by the authors.

                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 ( http://creativecommons.org/licenses/by/4.0/).

                : 22 November 2020
                : 22 January 2021

                anticonvulsants, epilepsy, meningioma, seizures, stampe2


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