Tanti M J, Marson A G, Jenkinson M D
The Walton Centre NHS Foundation Trust, Fazakerley, Liverpool, UK.
School of Medicine, University of Liverpool, Liverpool, UK.
Acta Neurol Scand. 2017 Sep;136(3):246-253. doi: 10.1111/ane.12711. Epub 2016 Nov 14.
Meningiomas are common intracranial tumors, and despite surgery or therapy with anti-epileptic drugs (AEDs), many patients suffer from seizures. Epilepsy has a significant impact on quality of life (QoL) in non-tumor populations, but the impact of epilepsy on QoL in patients with meningioma is unknown. Our aim was to evaluate the impact of epilepsy on QoL in patients that have undergone resection of a benign meningioma.
We recruited meningioma patients without epilepsy (n=109), meningioma patients with epilepsy (n=56), and epilepsy patients without meningioma (n=64). QoL was measured with the Short Form 36 version 2 (SF-36), the Functional Assessment of Cancer Therapy (FACT-BR), and the Liverpool Adverse Events Profile (LAEP). Regression analyses identified significant determinants of QoL.
Patients with meningioma and epilepsy had poorer QoL scores than meningioma patients without epilepsy in all measures. In FACT-BR, this difference was significant. Multiple regression analyses demonstrated that current AED use had a greater impact on QoL scores than recent seizures. Other variables associated with impaired QoL included depression, unemployment, and meningioma attributed symptoms.
Epilepsy has a negative impact on quality of life in patients with benign meningioma. AED use is correlated with impaired QoL and raised LAEP scores, suggesting that AEDs and adverse effects may have led to impaired QoL in our meningioma patients with epilepsy. The severity of epilepsy in our meningioma population was comparatively mild; therefore, a more conservative approach to AED therapy may be indicated in an attempt to minimize adverse effects.
脑膜瘤是常见的颅内肿瘤,尽管进行了手术或使用抗癫痫药物(AEDs)治疗,但许多患者仍遭受癫痫发作之苦。癫痫对非肿瘤人群的生活质量(QoL)有重大影响,但癫痫对脑膜瘤患者生活质量的影响尚不清楚。我们的目的是评估癫痫对已接受良性脑膜瘤切除术患者生活质量的影响。
我们招募了无癫痫的脑膜瘤患者(n = 109)、有癫痫的脑膜瘤患者(n = 56)和无脑膜瘤的癫痫患者(n = 64)。使用简明健康调查量表第2版(SF - 36)、癌症治疗功能评估量表(FACT - BR)和利物浦不良事件量表(LAEP)来测量生活质量。回归分析确定了生活质量的重要决定因素。
在所有测量指标中,有癫痫的脑膜瘤患者的生活质量得分均低于无癫痫的脑膜瘤患者。在FACT - BR量表中,这种差异具有统计学意义。多元回归分析表明,当前使用AEDs对生活质量得分的影响大于近期癫痫发作。与生活质量受损相关的其他变量包括抑郁、失业和脑膜瘤所致症状。
癫痫对良性脑膜瘤患者的生活质量有负面影响。AEDs的使用与生活质量受损和LAEP得分升高相关,这表明AEDs及其不良反应可能导致我们有癫痫的脑膜瘤患者生活质量受损。我们脑膜瘤患者群体中癫痫的严重程度相对较轻;因此,可能需要采用更保守的AEDs治疗方法,以尽量减少不良反应。