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Can developmental venous anomalies cause seizures?

Claire Dussaule1, Pascal Masnou2, Ghaïdaa Nasser3

  • 1Neurology Department, Hôpital Bicêtre, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris-Sud, 78 Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France. claire.dussaule@aphp.fr.

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Developmental venous anomalies (DVAs) can cause seizures, particularly when complicated by thrombosis or associated lesions. Isolated DVAs rarely cause epilepsy, and further research is needed to understand this link.

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Area of Science:

  • Neurology
  • Neuroscience
  • Vascular Neurology

Background:

  • Developmental venous anomalies (DVAs) are common congenital brain vascular malformations.
  • The association between DVAs and epilepsy, especially isolated DVAs, is not well understood.
  • DVAs are frequently incidental findings during seizure investigations.

Purpose of the Study:

  • To investigate the causal role of DVAs in seizures, focusing on cases without associated lesions.
  • To determine if isolated DVAs can directly cause epilepsy.
  • To analyze the mechanisms linking DVAs to seizures.

Main Methods:

  • Case series of four patients with DVAs presenting with seizures.
  • Utilized clinical history, cerebral MRI, EEG, and 18F-FDG PET.
  • Literature review of 30 additional cases (21 complicated DVAs, 9 potentially isolated DVAs).

Main Results:

  • Four patients presented with seizures attributed to DVA complications (thrombosis, infarction) or isolated DVAs with concordant epileptic foci.
  • Literature review identified seizures linked to complicated DVAs and a smaller number potentially linked to isolated DVAs.
  • Isolated, uncomplicated DVAs rarely cause seizures, and the underlying pathophysiology remains uncertain.

Conclusions:

  • Seizures associated with DVAs typically involve complications or co-existing epileptogenic lesions.
  • Thorough MRI protocols are crucial for identifying DVAs in patients with seizures.
  • The direct causal link between isolated DVAs and epilepsy is rare and requires further investigation into potential pathophysiological mechanisms.