Cerebral Arteriovenous Malformations and Epilepsy: Factors in the Development of Epilepsy

Crawford, Peggy; West, Christopher Robert; Shaw, M. D. M.

doi:10.1111/j.1528-1157.1986.tb03539.x

Cited by 107 publications

(60 citation statements)

References 5 publications

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“…Luhdorf et al [1986] report that the dominant cause of epilepsy in patients over 60 years is cerebrovascular disease, and oc currence of the seizures during the 1st week following stroke is a poor prognostic indica tor with higher mortality. Crawford et al [1986] observed that epilepsy results more commonly following hemorrhage, or with large enlarging arteriovenous malformations with superficial components, and following surgery for these malformations.…”

Section: Discussionmentioning

confidence: 99%

Case-Control Study of Associated Conditions at the Time of Death in Patients with Epilepsy

1988

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Analysis of mortality data based on underlying cause of death in epileptic patients is of limited value in view of the low case-fatality ratio of epilepsy. Recently the National Center for Health Statistics has made available all conditions mentioned on each death certificate for the entire US population. Using a case-control study design, we have analyzed all the associated conditions at the time of death in patients with epilepsy for the year 1978. Association between epilepsy and the following conditions reached statistical significance: mental retardation, cerebral palsy, cerebrovascular disease, myocardial ischemia, dementia, foreign body in pharynx and larynx, pneumonia, alcoholism and cirrhosis of liver. Early recognition and proper management of some of these factors could significantly reduce the mortality and morbidity in epileptic patients.

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Section: Discussionmentioning

confidence: 99%

Case-Control Study of Associated Conditions at the Time of Death in Patients with Epilepsy

1988

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“…IVMs and their associated aneurysms pose important but variable risks of sometimes recurrent intracranial hemorrhage and epilepsy, potentially leaving people with long-term disability and handicap. [2][3][4][5][6][7][8] Despite the importance of IVMs, there are few high-quality studies of their frequency, prognosis, and treatment. 9,10 Ideally, accurate estimates of detection should be based on complete, prospective ascertainment from a well-defined, stable population or a representative sample of one.…”

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confidence: 99%

Prospective, Population-Based Detection of Intracranial Vascular Malformations in Adults

Al‐Shahi

Bhattacharya²,

Currie³

et al. 2003

Stroke

400

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“…28,29 Only 1 observational study compared the risk of de novo seizures following AVM surgery to the risk during conservative management, finding that the risk was greater following surgery, but the study was retrospective and based on clinical practice between 1941 and 1984. 30 There have been no randomized controlled trials to compare seizure outcomes following AVM treatment vs conservative management. 31 Therefore, we conducted a prospective, population-based, observational cohort study and analyzed it to compare the risk of a first seizure, the risk of epilepsy, and the chances of achieving 2-year seizure freedom, for adults undergoing AVM treatment or conservative management.…”

mentioning

confidence: 99%

Seizure risk with AVM treatment or conservative management

Josephson¹,

Bhattacharya²,

Counsell³

et al. 2012

Neurology

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Methods:We used annual general practitioner follow-up, patient questionnaires, and medical records surveillance to quantify the 5-year risk of seizures and the chances of achieving 2-year seizure freedom for adults undergoing AVM treatment compared to adults managed conservatively in a prospective, population-based observational study of adults in Scotland, newly diagnosed with an AVM in 1999-2003. Results:We identified 229 adults with a new diagnosis of an AVM, of whom two-thirds received AVM treatment (154/229; 67%) during 1,862 person-years of follow-up (median completeness of follow-up 97%). There was no significant difference in the proportions with a first or recurrent seizure over 5 years following AVM treatment, compared to the first 5 years following clinical presentation in conservatively managed adults, in analyses stratified by mode of presentation (intracerebral hemorrhage, 35% vs 26%, p ϭ 0.5; seizure, 67% vs 72%, p ϭ 0.6; incidental, 21% vs 10%, p ϭ 0.4). For patients with epilepsy, the chances of achieving 2-year seizure freedom during 5-year follow-up were similar following AVM treatment (n ϭ 39; 52%, 95% confidence interval [CI] 36% to 68%) or conservative management (n ϭ 21; 57%, 95% CI 35% to 79%; p ϭ 0.7). Conclusions:In this observational study, there was no difference in the 5-year risk of seizures with AVM treatment or conservative management, irrespective of whether the AVM had presented with hemorrhage or epileptic seizures. Neurology Adults with a brain arteriovenous malformation (AVM) are at risk of epileptic seizures, especially when the AVM is supratentorial (in the temporal lobe in particular) and after intracerebral hemorrhage (ICH) has occurred.1 The main aim of AVM treatment is to reduce the risk of AVM-related ICH, but invasive procedures might also reduce the risk of seizures by obliterating epileptogenic foci. Conversely, surgical excision, endovascular embolization, and stereotactic radiosurgery could also raise the risk of seizures.Case series have reported conflicting results about seizure control following AVM treatment: surgery has been associated with better, 2-7 unchanged, or worse seizure control 8 -10 ; the effect of stereotactic radiosurgery has been promising, 11-21 although a delayed increase in seizure fre-

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Cerebral Arteriovenous Malformations and Epilepsy: Factors in the Development of Epilepsy

Cited by 107 publications

References 5 publications

Case-Control Study of Associated Conditions at the Time of Death in Patients with Epilepsy

Case-Control Study of Associated Conditions at the Time of Death in Patients with Epilepsy

Prospective, Population-Based Detection of Intracranial Vascular Malformations in Adults

Seizure risk with AVM treatment or conservative management

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