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. 2022 May;65(3):415-421.
doi: 10.3340/jkns.2020.0224. Epub 2022 Apr 29.

Long-Term Management of Seizures after Surgical Treatment of Supratentorial Cavernous Malformations : A Retrospective Single Centre Study

Tomasz A Dziedzic  1 , Kacper Koczyk  1 , Arkadiusz Nowak  1 , Edyta Maj  2 , Andrzej Marchel  1
Affiliations

Long-Term Management of Seizures after Surgical Treatment of Supratentorial Cavernous Malformations : A Retrospective Single Centre Study

Tomasz A Dziedzic et al. J Korean Neurosurg Soc. 2022 May.

Abstract

Objective: Seizure recurrence after the first-ever seizure in patients with a supratentorial cerebral cavernous malformation (CCM) is almost certain, so the diagnosis and treatment of epilepsy is justified. The optimal method of management of these patients is still a matter of debate. The aim of our study was to identify factors associated with postoperative seizure control and assess the surgical morbidity rate.

Methods: We retrospectively analysed 45 consecutive patients with a supratentorial CCM and symptomatic epilepsy in a single centre. Pre- and postoperative epidemiological data, seizure-related patient histories, neuroimaging results, surgery details and outcomes were obtained from hospital medical records. Seizure outcomes were assessed at least 12 months after surgery.

Results: Thirty-five patients (77.8%) were seizure free at the long-term follow-up (Engel class I); six (13,3%) had rare, nocturnal seizures (Engel class II); and four (8.9%) showed meaningful improvement (Engel class III). In 15 patients (33%) in the Engel I group; it was possible to discontinue antiepileptic medication. Although there was not statistical significance, our results suggest that patients can benefit from early surgery. No deaths occurred in our study, and mild postoperative neurologic deficits were observed in two patients (4%) at the long-term follow-up.

Conclusion: Surgical resection of CCMs should be considered in all patients with a supratentorial malformation and epilepsy due to the favourable surgical results in terms of the epileptic seizure control rate and low postoperative morbidity risk, despite the use of different predictors for the seizure outcome.

Keywords: Drug reistant epilepsy; Epilepsy outcome; Epilepsy surgery; Hemangioma, cavernous, central nervous system.

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Conflict of interest statement

Conflicts of interest

No potential conflict of interest relevant to this article was reported.

References

    1. Akers A, Al-Shahi Salman R, Awad IA, Dahlem K, Flemming K, Hart B, et al. Synopsis of guidelines for the clinical management of cerebral cavernous malformations: consensus recommendations based on systematic literature review by the Angioma Alliance Scientific Advisory Board clinical experts panel. Neurosurgery. 2017;80:665–680. - PMC - PubMed
    1. Baumann CR, Acciarri N, Bertalanffy H, Devinsky O, Elger CE, Lo Russo G, et al. Seizure outcome after resection of supratentorial cavernous malformations: a study of 168 patients. Epilepsia. 2007;48:559–563. - PubMed
    1. Cappabianca P, Alfieri A, Maiuri F, Mariniello G, Cirillo S, de Divitiis E. Supratentorial cavernous malformations and epilepsy: seizure outcome after lesionectomy on a series of 35 patients. Clin Neurol Neurosurg. 1997;99:179–183. - PubMed
    1. Casazza M, Broggi G, Franzini A, Avanzini G, Spreafico R, Bracchi M, et al. Supratentorial cavernous angiomas and epileptic seizures: preoperative course and postoperative outcome. Neurosurgery. 1996;39:26–32. discussion 32-34. - PubMed
    1. Chang EF, Gabriel RA, Potts MB, Garcia PA, Barbaro NM, Lawton MT. Seizure characteristics and control after microsurgical resection of supratentorial cerebral cavernous malformations. Neurosurgery. 2009;65:31–37. discussion 37-38. - PubMed

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