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Epileptic seizures at initial presentation in patients with brain arteriovenous malformation

B Garcin1, E Houdart, R Porcher

  • 1Department of Neurology, APHP Hôpital Lariboisière, Paris, France.

Neurology
|February 21, 2012
PubMed
Abstract

Insights

Seizures are common in brain arteriovenous malformations (AVMs), especially those with superficial venous drainage. Male sex, larger AVM size, and frontal lobe location also increase seizure risk.

Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • Brain arteriovenous malformations (AVMs) are complex vascular lesions.
  • Epileptic seizures are a frequent presenting symptom of brain AVMs.
  • Limited prospective data exist on AVM morphology and seizure risk.

Purpose of the Study:

  • To investigate the relationship between AVM morphologic characteristics and the risk of seizures as an initial presentation.
  • To identify specific AVM features associated with seizure occurrence in unruptured cases.

Main Methods:

  • Prospective study of 155 consecutive patients with brain AVMs.
  • Analysis of demographic and morphologic factors using MRI and digital subtraction angiography (DSA).
  • Univariate and multivariate logistic regression models were employed.

Main Results:

  • 29% of patients presented with seizures.
  • Superficial venous drainage, male sex, larger AVM size, frontal lobe, and arterial borderzone locations were associated with seizures.
  • Multivariate analysis confirmed independent effects of male sex, frontal lobe AVMs, and arterial borderzone location.

Conclusions:

  • Superficial venous drainage is a key factor in AVM-related seizures.
  • Male sex, increasing AVM size, and specific locations (frontal lobe, arterial borderzone) are additional risk factors.
  • The long-term impact of interventional treatment on epilepsy risk requires further investigation.

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