Introduction Treatment of structural epilepsy in patients with cerebral arteriovenous malformations (AVMs) is an important and complex task.
Aim of Study To compare the course of structural epilepsy in AVM patients after endovascular and combined treatment using the Engel scale.
Methods 229 adult patients (18 to 69yrs) were included in the study. Of these, 133 were men and 96 women. Of these, 174pts(76%) underwent only embolization, 34pts(14.8%) embolization + microsurgery, 21pts(9.2%) embolization + radiosurgery. According to the Spetzler-Ponce classification, 53pts(23.2%) suffered from Grade A, 102pts(44.5%) Grade B, 74pts(32.3%) Grade C AVMs. A total of 736 sessions were carried out with 3 sessions per patient on average. The average follow-up period was 4yrs.
Results The AVMs totally obliterated in 114pts(49.8%), subtotally in 12pts(5.2%), partially in 103pts(45%). Embolization alone led to total occlusion in 59pts(51.8%); combined treatment in 55pts(24%) of them 34pts(29.8%) underwent embolization + microsurgery and 21pts(18.4%) embolization + radiosurgery.
The Engel classification Class1 was achieved by 47pts(20.5%) after embolization alone; 26pts(11.3%) after embolization + microsurgery; 14pts(6.1%) after embolization + radiosurgery.
The patients developed the following complications: 1 death (0.4%), 1 severe neurological deficit (0.4%), and 18 incomplete recoveries after surgery (7.9%).
Conclusion Treating structural epilepsy in AVM patients should include all available methods to achieve freedom from seizures in order to improve their quality of life. Endovascular embolization can be used as an independent method for AVM treatment with a good clinical effect in relation to epileptic seizure control and be applied in combination with other known AVM treatment methods.
Disclosure of Interest No conflicts of interest
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.