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Intractable epilepsy associated with multiple cavernous malformations: case report.

T Akimura1, M Fujii, H Adachi

  • 1Department of Neurosurgery, Yamaguchi University School of Medicine, Ube, Japan.

Neurosurgery
|March 17, 2000
PubMed
Summary
This summary is machine-generated.

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Epilepsy from multiple cavernous malformations can be treated with a single surgery. This case study highlights successful seizure control after one gyrus resection for intractable epilepsy.

Area of Science:

  • Neurosurgery
  • Epileptology
  • Neuroradiology

Background:

  • Epilepsy associated with cavernous malformations (CMs) often requires surgical intervention.
  • Multiple CMs and medically intractable seizures necessitate thorough preoperative evaluation.
  • Lesionectomy is a common treatment, but outcomes vary with lesion complexity.

Observation:

  • A 25-year-old male presented with a decade-long history of medically intractable complex partial and generalized seizures.
  • Magnetic Resonance Imaging (MRI) revealed over ten cavernous malformations.
  • Video-electroencephalography (VEEG) monitoring localized seizure onset to the right frontal or temporal lobe.

Findings:

  • Intracranial EEG monitoring confirmed seizure origin in the right frontal lobe.

Related Experiment Videos

  • A single gyrus resection, including a calcified CM, and multiple subpial transections were performed.
  • The patient achieved 22 months of seizure freedom post-operatively.

    • Implications:

    • A single resective procedure can effectively control medically intractable seizures in patients with multiple cavernous angiomas.
    • VEEG monitoring is crucial for accurate seizure focus localization in complex epilepsy cases.
    • This approach offers a potential treatment strategy for similar challenging epilepsy cases.