Seizures in Intracranial Lipomas: Insights from a Systematic Review of 78 Cases
Oreoluwa Morakinyo1, Aliu Yakubu1, Chukwuma Nwaze2, Toheeb Bakare3
1Neurology, University of Texas Medical Branch, 2Neurology, Lagos University Teaching Hospital, 3Neurology, SUNY Downstate
Objective:
To characterize seizure features in patients with intracranial lipomas, explore links between lesion location and seizure type, assess whether the association is causal or coincidental, and review medical and surgical treatments for seizure control.
Background:
Intracranial lipomas are rare midline, congenital malformations, often detected incidentally and are asymptomatic. However, they can occasionally present with seizures. Due to the rarity of this condition, the clinical spectrum of seizure associated with intracranial lipomas and management remain poorly characterized.
Design/Methods:
We conducted a systematic review following PRISMA guidelines to identify cases of intracranial lipomas associated with seizures. Searches were performed in PubMed, Embase, and Google Scholar up to March 2025. Case reports and case series describing seizure presentation, imaging findings, management, and outcomes were included.
Results:
A total of 72 studies involving 78 patients were included. Generalized seizures (43.5%) and focal seizures (39.7%) were the most common types. Lipomas were most frequently located in midline structures, particularly the corpus callosum (30.7%). Structural brain anomalies coexisted in 69.2% of cases. Patients with associated anomalies tended to present earlier and more frequently with focal seizures, while isolated lipomas were more commonly linked to generalized seizures. Antiepileptic drugs were effective in the majority of cases, with 78.3% achieving seizure control or remission. Surgical intervention was performed in 28.2% of cases, primarily for refractory seizures or mass effect, and most resulted in favorable outcomes. Overall, seizure control was achieved in over 85% of cases, and no progression of lipomas was reported during follow-up
Conclusions:
Intracranial lipomas presenting with seizures are rare but typically benign. Seizure control is achievable with medical therapy in most cases, and surgery may benefit selected patients with refractory symptoms or mass effect. Early recognition and individualized management lead to favorable outcomes.
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