Earlier Age at Surgery for Brain Cavernous Angioma-Related Epilepsy May Achieve Complete Seizure Freedom Without Aid of Anti-Seizure Medication

Overview

Journal Brain Sci

Publisher MDPI

Date 2022 Mar 25

PMID 35326359

Authors

Ayataka Fujimoto

Hideo Enoki

Keisuke Hatano

Keishiro Sato

Tohru Okanishi

Affiliations

Soon will be listed here.

Abstract

Background: The present study hypothesized that some factors may distinguish between patients with a brain cavernous angioma (BCA), who were free from anti-seizure medication (ASM), and patients who still required ASMs postoperatively. The purpose of the study was thus to identify factors associated with ceasing ASMs for patients with drug-resistant epilepsy secondary to BCA, who underwent BCA removal surgery.

Methods: We divided patients into those with drug-resistant epilepsy secondary to BCA who achieved complete seizure freedom without ASMs a year after surgery (No-ASM group) (International League Against Epilepsy (ILAE) classification class I with no epileptiform discharges), and others (ASM group) (ILAE classification ≤ II and/or epileptiform discharges). We statistically compared groups in terms of: (1) age at operation; (2) history of epilepsy; (3) size of BCA; and (4) location of BCA.

Results: Overall, a year after the surgery, the No-ASM group comprised 12 patients (48%), and the ASM group comprised 13 patients (52%). In both multi- and univariate logistic regression analyses, age at BCA removal surgery correlated significantly with the No-ASM group ( = 0.043, = 0.019), but history of epilepsy did not ( = 0.581, = 0.585).

Conclusions: Earlier age at surgery for patients with drug-resistant epilepsy is encouraged to achieve complete seizure freedom without the need for ASMs when the cause of epilepsy is BCA.

Citing Articles

Cavernous malformation located medially and deeply in the brain may be prone to false lateralization in cavernous malformation-associated epilepsy.

Hatano K, Sato K, Nakamura T, Hotta R, Numoto S, Fujimoto A Heliyon. 2024; 10(6):e28273.

PMID: 38545148 PMC: 10966682. DOI: 10.1016/j.heliyon.2024.e28273.

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