Abstract
Objective: To describe seizure outcome and complications in patients with cavernous malformations (CM) undergoing early versus late surgery. Methods: A database was created for all CM patients who presented with seizure referred to the neurosurgical clinic at an academic center. A telephone survey and chart review were conducted to evaluate for preoperative and postoperative seizure frequency. Postoperative seizure-free outcome of patients who had ≤2 preoperative seizures versus those that had >2 preoperative seizures was compared. Results: A total of 35 CM patients were included for analysis. Nineteen patients had ≤2 preoperative seizures and 16 patients had >2 preoperative seizures, six of them drug resistant for over two years. Among the ≤2 seizure group, 15 had only a single seizure before surgical resection. 94.7% of patients with ≤2 preoperative seizures and 62.5% of patients with >2 preoperative seizures were seizure free one year following surgical resection (p = 0.019). 78.9% of patients with ≤2 preoperative seizures and 25% of patients with >2 preoperative seizures were able to wean off AEDs (p < 0.001). Among those patients who had a single preoperative seizure, 100% of patients were seizure free at one year. Conclusions: Early surgical resection for CM patients who present after a CM-related seizure is an effective, well tolerated treatment and has good chance to offer seizure freedom without the need for long-term antiepileptic medications. Outcome for patients operated with only one or two preoperative seizures may lead to better results than patients who delay the procedure.
Original language | English (US) |
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Article number | 107662 |
Journal | Epilepsy and Behavior |
Volume | 115 |
DOIs | |
State | Published - Feb 2021 |
Keywords
- Cavernoma
- Cavernous malformation
- Epilepsy surgery
- First seizure
- Intractable epilepsy
ASJC Scopus subject areas
- Neurology
- Clinical Neurology
- Behavioral Neuroscience