Predictive factors of epilepsy in arteriovenous malformation - 19/06/20
, H. Cebula a, J. Todeschi a, M.D.N. Santin a, F. Séverac b, M.P. Valenti-Hirsch c, E. Hirsch c, F. Proust aBienvenue sur EM-consulte, la référence des professionnels de santé.
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| pages | 6 |
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Highlights |
• | Structural epilepsy concerned 27.5% of patients with cerebral arteriovenous malformations. |
• | Young age, large nidus, venous dilation and high Martin-Spetzler grade were significant factors associated with epilepsy in AVM, using univariate analysis. |
• | Posterior cerebral artery feeder AVM was associated with epilepsy, based on multivariate analysis. |
Abstract |
Objective |
Structural epilepsy related to cerebral arteriovenous malformation (AVM) suggests different epileptogenic mechanisms. The aim of our study was to determine factors associated with epilepsy into a retrospective cohort of AVM patients.
Patients and methods |
Ruptured and unruptured AVM data retrieved from a prospective single center registry (2009–2016) were retrospectively assessed. Demographic, clinical and radiological features were identified in AVM patients with or without epilepsy according to the International League Against Epilepsy classification.
Results |
Epilepsy concerned 22 out of 80 consecutive patients with AVM (27.5%). Univariate analysis comparing both groups revealed a significant association of different variables with the structural epilepsy: young age (P=0.02), large nidus size (P=0.02), venous dilation (P=0.02), posterior cerebral artery (PCA) feeder (P<0.001) and Spetzler-Martin grade (P=0.02). Based on multivariate analysis, only the PCA feeder was identified (OR=5.2 [95% CI 1.1–24,5], P=0.04).
Conclusion |
PCA feeder for cerebral AVM was significantly associated with structural epilepsy. The hypothesis of a vascular steal phenomenon to the detriment of internal temporal lobe vascularization could be related to the development of epilepsy.
Le texte complet de cet article est disponible en PDF.Keywords : Cerebral arteriovenous malformation, AVM, Structural epilepsy, Seizure, Cerebral posterior artery
Plan
Vol 66 - N° 3
P. 144-149 - juin 2020 Retour au numéro
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