Epilepsy associated with cerebral cavernous malformations managed with stereotactic radiosurgery: an international,...

Area of Science:

• Neurosurgery
• Neurology
• Radiology

Background:

• Stereotactic radiosurgery (SRS) is an alternative to resection for epilepsy in patients with cerebral cavernous malformations (CCM) in critical brain areas.
• Cerebral cavernous malformations can cause debilitating seizures, impacting quality of life.

Purpose of the Study:

• To evaluate the effectiveness of SRS in controlling seizures in patients with solitary CCM.
• To identify factors influencing seizure control outcomes after SRS for CCM.

Main Methods:

• Multicentric, retrospective study design.
• Inclusion of 109 patients with solitary CCM and prior seizures.
• Assessment of seizure control using Engel classification at a median follow-up of 3.5 years post-SRS.

Main Results:

• 47.7% of patients achieved Engel class I (seizure-free) outcome.
• A delay of over 1.5 years between epilepsy presentation and SRS was associated with a lower probability of seizure freedom (HR 0.25).
• Among patients with drug-resistant epilepsy, 22.2% achieved Engel class I outcome post-SRS.

Conclusions:

• SRS is an effective treatment option for seizure control in select patients with solitary CCM.
• Timely intervention with SRS may improve seizure control outcomes.
• Further research is warranted to optimize SRS treatment protocols for CCM-related epilepsy.