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Published on: September 17, 2014
Effect of Targeted Embolization on Seizure Outcomes in Patients with Brain Arteriovenous Malformations
Chingiz Nurimanov1, Aisha Babi2, Karashash Menlibayeva2
1Vascular and Functional Neurosurgery Department, National Center for Neurosurgery, Astana 010000, Kazakhstan.
Insights
Curative embolization positively impacted seizures in brain arteriovenous malformation (AVM) patients, though inadequate antiepileptic drug (AED) treatment affected outcomes. Further research with careful patient selection is recommended.
Area of Science:
- Neurology
- Neurosurgery
- Interventional Radiology
Background:
- Seizures are a significant complication of brain arteriovenous malformations (AVMs).
- Evaluating the efficacy of embolization in managing seizures associated with brain AVMs is crucial.
Purpose of the Study:
- To assess the impact of curative embolization on seizure presentation in patients with brain AVMs.
- To identify factors influencing seizure outcomes and complications post-embolization.
Main Methods:
- Retrospective analysis of brain AVM patients who underwent embolization (2012-2020).
- Patient interviews and seizure outcome evaluation using International League Against Epilepsy (ILAE) and Engel classifications.
- Statistical analysis including ANOVA and Fischer's exact tests for outcome and complication factors.
Main Results:
- 50% of patients experienced positive seizure dynamics post-embolization.
- Shorter seizure history correlated with better seizure control (Engel and ILAE scores).
- Inadequate pre-embolization antiepileptic drug (AED) dosages were noted in over 80% of patients.
Conclusions:
- Embolization offers a positive effect on seizure presentation in brain AVM patients with low complication rates.
- Suboptimal AED management complicates the interpretation of results, highlighting the need for prospective studies.
- Careful patient selection and optimized AED protocols are essential for future research.
Background:
Seizures are one of the most debilitating manifestations of brain arteriovenous malformations (AVMs). This study aimed to evaluate the effect of curative embolization on brain AVM patients presenting with seizures.
Methods:
The records of patients who underwent embolization for brain AVM from January 2012 to December 2020 were evaluated and patients presenting with seizures were interviewed. Patient responses were evaluated according to the International League Against Epilepsy (ILAE) and Engel classifications. Statistical analyses of factors associated with seizure outcomes and complications were performed using ANOVA and Fischer's exact tests.
Results:
The mean age of the participants was 35.2 ± 10.7 years. More than 80% of the patients received no or suboptimal dosages of antiepileptic drugs (AEDs) prior to embolization. Positive seizure dynamics were observed in 50% of the patients post-procedure. A correlation was found between length of seizures in anamnesis and outcomes of both Engel and ILAE score, where shorter length was associated with better outcomes. Post-embolization hemorrhage was associated with initial presentation with hemorrhage.
Conclusions:
The embolization of brain AVMs had a positive effect on seizure presentation and a relatively low prevalence of complications. However, the results of the study are obscured by inadequate AED treatment received by the patients, which prompts prospective studies on the topic with careful patient selection.
