Padaczka u kobiet z guzami oponówkowymi mózgu związanymi ze stosowaniem progestagenów

PURPOSE: Progestogen-associated intracranial meningiomas are increasingly recognized as a distinct clinical entity, often characterized by multiplicity and preferential skull-base location. However, epilepsy in this population remains poorly characterized. We aimed to assess the prevalence, clinical features, and factors associated with epilepsy in women with progestogen-associated meningiomas. METHOD: We retrospectively analyzed consecutive adult women managed for intracranial meningioma at a tertiary neuro-oncology center between 2000 and 2024, with documented exposure to at least one progestogen associated with increased meningioma risk and available clinical and imaging data. Epilepsy was analyzed at the patient level using one index meningioma per patient. Given the low number of epilepsy events, analyses were descriptive. RESULTS: A total of 209 women were included (mean age 51.9 ± 10.1 years), including 69 (33.0%) with multiple meningiomas. Epilepsy at diagnosis occurred in 4.8% of patients and in 13.3% of symptomatic patients. Patients with epilepsy had larger index meningiomas than those without (24.6±24.3 vs 8.8 ± 16.9 cm), more frequent meningioma-related brain edema (70.0% vs 19.1%), and more frequent midline mass effect (60.0% vs 13.6%). No association was detected with progestogen type or exposure pattern. Following antiseizure medication initiation, seizures were controlled in all patients with epilepsy at diagnosis. At last follow-up, seizures were controlled in 7/9 (77.8%) evaluable patients. During follow-up, de novo epilepsy remained uncommon, particularly among patients initially managed conservatively. CONCLUSION: Epilepsy is uncommon in women with progestogen-associated intracranial meningiomas. When present, it appears to be primarily related to tumor burden and meningioma-brain interface involvement, whereas no association with specific progestogen exposure characteristics was detected.