Stereotactic multiple arc radiotherapy. III--Influence of treatment of arteriovenous malformations on associated...

Although radiosurgery obliterates the majority of arteriovenous malformations (AVMs) and cures patients of further haemorrhage, the perceived beneficial effect on the epilepsy associated with it is less certain. Two recent publications suggest that radiosurgery benefits the associated epilepsy. In a consecutive series of 101 AVM patients presenting for radiosurgery to St Bartholomew's Hospital, 24 had a history of fits; 16 were evaluable for analysis of fit control. Fifteen of the sixteen patients (94%) had improvement in fit control, 10/16 (63%) becoming fit free. This improvement appeared to correlate with response to treatment on follow-up angiography and in 11/15 patients this occurred with no change or a reduction in anticonvulsant in medication. No patient suffered a deterioration in the epilepsy. These data are discussed in the context of the only two previous reports in the literature and the mechanisms of action of treatment.