New approaches for brain arteriovenous malformations-related epilepsy - 10/03/23
Highlights |
• | A large variety of genetic, molecular, and biological factors are involved in the process of brain arteriovenous malformations (bAVM) formation. |
• | Epileptogenesis related to the presence of sbAVM is likely specific for this pathology. |
• | Several evidences demonstrated a bidirectional relationship between these entities. |
• | Modern imaging modalities are required to understand more about the behavior of bAVM in order to treat them effectively. |
• | Current treatments are highly invasive and often not feasible. Thus, effective noninvasive treatments are needed. |
• | For unruptured and untreatable bAVM, a new therapeutic concept will be necessary, to stabilize vascular tissue, to decrease the risk of hemorrhage and indirectly the epileptic risk. Treatments other than AEDs could be beneficial for both pathologies. |
Abstract |
Background |
The purpose of this review is to present the current literature and to highlight the most recent findings in brain arteriovenous malformations (bAVM)-related epilepsy research.
Methods |
We searched Medline, PubMed, Biblioinserm, Cochrane Central to study the latest research reports about the different factors that could be responsible for the genesis of bAVM-related epilepsy. We analyzed if epileptogenesis has any characteristics traits and its relation with the vascular malformation. The results of different treatments on epilepsy were considered. Typical errors that may lead towards incorrect or worse management of the seizures for these patients were also examined.
Results |
The development of bAVM results from multifactorial etiologies and bAVM-related epileptogenesis is likely specific for this pathology. Different types of evidence demonstrate a bidirectional relationship between bAVM and epilepsy. Currently, there is not enough published data to determine what may be the right management for these patients.
Conclusions |
A better understanding of epileptogenesis in conjunction with knowledge of the complex alterations of structures and functions following bAVM-related seizures is necessary. Identification of biomarkers that can identify subgroups most likely to benefit from a specific intervention are needed to help guide clinical management. A new concept for the treatment of epilepsy related to an unruptured bAVM that cannot be treated invasively is proposed as well as new therapeutic perspectives. The next necessary step will be to propose additional algorithms to improve the development of future trials.
Le texte complet de cet article est disponible en PDF.Keywords : Sporadic brain arteriovenous malformations, Epilepsy, Seizures, Genetics, Molecular, Exportation, Treatment, Endovascular embolization, Stereotaxic radiosurgery, Microsurgery
Abbreviations : AED, ANGPT, ARUBA, BBB, BDNF, BRAF, CM, DRE, DSA, EVE, ECI, ECoG, EEG, ERK, ET, FGF, MRI, ICH, ICG, ILAE, KRAS, y, LncRNA, LPL, MS, MMT, MFUD, min, max, MAPK/MEK, miR-18a, miRNA, MMP-9, mo, NADPH, NRAS, NVU, NVC, OAP1, PDGF, PET, RAS, sbAVM, SNP, SRS, TGF-β, VEGF, 18F-FDG PET, 4DFlow MRI
Plan
Vol 179 - N° 3
P. 188-200 - mars 2023 Retour au numéro
Article précédent
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