From 1979 to 1990, 223 patients with cerebral arteriovenous malformations were surgically treated by authors. Among these, 196 patients with totally resected AVM were followed for mean duration of 5.3 years. Their record were reviewed with special focus on the preoperative seizure history and follow- up seizure status. The authors observed the onset of new seizures in 21 (16.3%) of 129 patients who did not have seizures before surgery. Among these, however, 9 had only one or two seizures during the early postoperative period, and the other 12 had only rare persistent seizures that were well controlled with medications. Among 67 patients with preoperative epilepsy, 35 (52.2%) experienced no seizures for more than 2 years after surgery and 20 of them were receiving no anticonvulsant medication. Among 32 (47.8%) patients who continued to have seizures, the frequency of seizures improved in 10, remained unchanged in 18 and was worse in 4. There was a statistically significant relationships between the duration of preoperative epilepsy and the postoperative seizure status. The patients whose seizure duration was one years or less had a better chance to improve their seizures than the patients with a seizure history of more than one year. The author's conclusion is that the risk of persistent epilepsy after surgery is small in those patients who did not have seizures preoperatively, and that preoperative epilepsy has a strong tendency to improve after excision of the AVM.
ASJC Scopus subject areas
- Clinical Neurology