Edelbach Brandon, Lopez-Gonzalez Miguel Angel
School of Medicine, Loma Linda University, Loma Linda, California, United States.
Department of Neurosurgery, Loma Linda University Medical Center East Campus, Loma Linda, California, United States.
J Neurol Surg B Skull Base. 2024 May 3;86(3):254-261. doi: 10.1055/a-2297-8981. eCollection 2025 Jun.
This study aims to investigate the association between giant anterior and middle fossa skull base tumors and epilepsy, and implications for clinical management. A retrospective analysis was conducted on a cohort of patients diagnosed with anterior skull base tumors between 2016 and 2023. Radiologic data were used to identify tumors with major diameter larger than 5 cm involving skull base with intracranial involvement. Relevant demographic information, tumor characteristics, seizure type, seizure frequency, and treatment outcomes were analyzed. Among the 236 patients diagnosed and operated with skull base tumors by senior author, 7.63% ( = 18) had giant skull base tumors of anterior and middle fossa, and 2.96% ( = 7) presented with concurrent epilepsy. Overall, in giant anterior and middle fossa skull base tumors, epilepsy was present in 38% of cases. The average age at operation was 47.56 ± 16.96, with 44.4% of cases being male and 55.6% of the cases being female. The majority of these cases exhibited focal epilepsy (71%), characterized by seizures originating from the proximity of the tumor location suggesting a potential correlation between tumor location and seizure generation. Of the remaining, 29% were generalized seizures. Tumors of the anterior fossa included 11 meningiomas, 3 pituitary adenomas, 1 chondrosarcoma, 1 hemangiopericytoma, 1 schwannoma, and 1 adenoid cyst carcinoma; half of which ( = 9) were of low grade. Our findings provide evidence of low frequency of epilepsy in skull base tumors in general, with an association among giant anterior and middle fossa skull base tumor and epilepsy.
本研究旨在探讨巨大的前颅窝和中颅窝颅底肿瘤与癫痫之间的关联及其对临床管理的意义。 对2016年至2023年间诊断为前颅底肿瘤的一组患者进行了回顾性分析。利用放射学数据来识别主要直径大于5厘米、累及颅底并伴有颅内侵犯的肿瘤。分析了相关的人口统计学信息、肿瘤特征、癫痫发作类型、发作频率和治疗结果。 在由资深作者诊断并接受颅底肿瘤手术的236例患者中，7.63%（n = 18）患有前颅窝和中颅窝巨大颅底肿瘤，2.96%（n = 7）并发癫痫。总体而言，在前颅窝和中颅窝巨大颅底肿瘤中，38%的病例存在癫痫。手术的平均年龄为47.56±16.96岁，44.4%的病例为男性，55.6%的病例为女性。这些病例中的大多数表现为局灶性癫痫（71%），其特征是癫痫发作起源于肿瘤位置附近，提示肿瘤位置与癫痫发作之间可能存在关联。其余病例中，29%为全身性癫痫发作。前颅窝肿瘤包括11例脑膜瘤、3例垂体腺瘤、1例软骨肉瘤、1例血管外皮细胞瘤、1例神经鞘瘤和1例腺样囊性癌；其中一半（n = 9）为低级别肿瘤。 我们的研究结果表明，一般来说颅底肿瘤中癫痫的发生率较低，前颅窝和中颅窝巨大颅底肿瘤与癫痫之间存在关联。
