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Epileptogenicity of supratentorial medullary venous malformation

Takato Morioka1, Kimiaki Hashiguchi, Shinji Nagata

  • 1Department of Neurosurgery, Kyushu University, Graduate School of Medical Sciences, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan. takato@ns.med.kyushu-u.ac.jp

Epilepsia
|February 28, 2006
PubMed
Abstract

Insights

Medullary venous malformations (MVMs) are not typically epileptogenic. However, intracerebral hemorrhage associated with MVMs can cause epilepsy, especially when a cavernous angioma (CA) is also present.

Area of Science:

  • Neurology
  • Neurosurgery
  • Epileptology

Background:

  • Supratentorial medullary venous malformations (MVMs) are rare vascular anomalies.
  • The epileptogenic potential of MVMs, particularly in relation to intracerebral hemorrhage and associated vascular malformations, requires further investigation.

Purpose of the Study:

  • To evaluate the epileptogenicity of supratentorial medullary venous malformations (MVMs).
  • To examine the association between MVMs, intracerebral hemorrhage, and epilepsy.
  • To investigate the role of co-existing vascular malformations, such as cavernous angiomas (CAs), in MVM-related epilepsy.

Main Methods:

  • Retrospective review of 10 patients with verified MVMs.
  • Classification of patients into groups with or without intracerebral hemorrhage.
  • Analysis of clinical, neuroradiologic, and electroencephalogram (EEG) findings, including interictal and ictal recordings.

Main Results:

  • Epilepsy occurred in 3/5 patients without hemorrhage, but without topographic concordance between MVM location and EEG focus.
  • Epilepsy developed in 4/5 patients with hemorrhage, showing topographic concordance between the hemorrhagic MVM site and EEG focus.
  • A patient with hemorrhagic MVM and hippocampal CA presented with intractable medial temporal lobe epilepsy.

Conclusions:

  • Supratentorial MVMs are generally not epileptogenic on their own.
  • Intracerebral hemorrhage associated with MVMs can induce epilepsy.
  • Co-existing cavernous angiomas (CAs) may significantly contribute to epileptogenesis in the context of MVMs.

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