Relationship between tumour location and preoperative seizure incidence in patients with gliomas: a systematic review and meta‐analysis

Abstract Aim . The aim of this meta‐analysis was to assess the relationship between tumour location and preoperative seizure incidence in patients with gliomas. Methods . Systematic computerised searches of PubMed and the Web of Knowledge were performed. The meta‐analysis of pooled odds ratio (OR) and 95% confidence interval (CI) for preoperative seizure risk, stratified by tumour location, were calculated. Results . Eleven studies with 2,047 patients were included for meta‐analysis. For gliomas with or without frontal lobe involvement, the preoperative seizure incidence ranged from 31.7% (19/60) to 85.7% (156/182) and 19.7% (12/61) to 85.7% (12/14), respectively; the pooled OR was 1.560 (95% CI: 1.266–1.923; Z: 4.17; p =0.000). For gliomas with or without temporal lobe involvement, seizure incidence was 22.6% (7/31) to 91.7% (11/12) and 26.7% (24/90) to 78.7% (174/221), respectively; the pooled OR was 1.070 (95% CI: 0.794–1.443; Z: 0.45; p =0.656). For gliomas with or without parietal lobe involvement, seizure incidence was 18.1% (3/16) to 100.0% (3/3) and 26.7% (28/105) to 80.4% (226/281), respectively; the pooled OR was 0.770 (95% CI: 0.570–1.040; Z: 1.71; p =0.088). For gliomas with or without occipital lobe involvement, seizure incidence was 0.0% (0/2) to 100.0% (2/2) and 26.8% (30/112) to 75.7% (56/74), respectively; the pooled OR was 0.336 (95% CI: 0.164–0.686; Z: 2.99; p =0.003). For gliomas with or without insula lobe involvement, seizure incidence was 34.8% (8/23) to 72.0% (77/107) and 34.3% (60/175) to 81.3% (247/304), respectively; the pooled OR was 1.058 (95% CI: 0.765–1.463; Z: 0.34; p =0.732). No significant publication bias was found. Conclusion . Our meta‐analysis indicates that frontal lobe gliomas are related to a higher preoperative seizure incidence, while occipital lobe gliomas are related to a lower incidence.