Predictive factors of epilepsy in a cohort of brain arteriovenous malformation patients with a 5-year follow-up - 17/10/25

Doi : 10.1016/j.neurol.2025.09.007

B.O. Pirlog ^a,^b,⁎, ^{^{1
These authors contributed equally to this work.},}^{^{2
Twitter: @PirlogBianca.}} , M. Porché ^a,^{^{1
These authors contributed equally to this work.}}, M. Kyheng ^c, J. Labreuche ^d, A. Taleb ^e, E. Dubus ^e, E. Houdart ^f, M. Mazighi ^a,^g,^h,ⁱ
^a Neurology Department, Lariboisière Hospital, FHU NeuroVasc, AP–HP Nord, 75010 Paris, France
^b Neurology Department, Emergency County Hospital Cluj-Napoca, Cluj-Napoca, Romania
^c ULR 2694 – METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, Université de Lille, CHU de Lille, 59000 Lille, France
^d Biostatistics Department, CHU de Lille, 59000 Lille, France
^e Neurology Department, Centre NeuroVasculaire Translationnel, Lariboisière Hospital, FHU NeuroVasc, AP–HP Nord, Paris, France
^f Department of Neuroradiology, Lariboisière Hospital, FHU NeuroVasc, AP–HP Nord, Paris, France
^g Inserm UMR 1144, Université Paris-Cité, Paris, France
^h Institut Universitaire de France, Paris, France
ⁱ StrokeLink Network, Paris, France

^⁎Corresponding author. Neurology Department, Lariboisière Hospital, FHU NeuroVasc, AP–HP Nord, 75010 Paris, France.Neurology Department, Lariboisière Hospital, FHU NeuroVasc, AP–HP NordParis75010France

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Friday 17 October 2025

Abstract

Background and aims

Data on factors associated with new-onset epilepsy in the follow-up of patients with brain arteriovenous malformations (BAVM) are scarce. We aimed to characterize the baseline patient and BAVM characteristics related to epilepsy and the predictive factors of new-onset epilepsy in BAVM patients during their follow-up.

Patients and methods

We retrospectively analyzed 200 BAVM patients treated between 2000 and 2023. We used univariate and multivariate analyses to assess the association between baseline characteristics and seizures. The risk of developing seizures during follow-up was estimated using nonparametric survival analysis for interval-censored data.

Results

In the present cohort, 90/200 patients (45%) had epilepsy at baseline. Patients with epilepsy were predominantly men (71.1%), and alcohol users (18.8%), and presented with BAVM located more often in the frontal lobe (55.6%) as compared to patients without epilepsy (40%, 7.4%, 23.6% respectively). Male gender was associated with higher prevalence of seizures at inclusion (OR 3.81 [95%CI, 1.77; 8.24]), while headaches (OR 0.19 [95% CI, 0.09; 0.41]), focal deficit (OR 0.22 [0.09; 0.49]) and BAVM occipital localization (OR 0.16 [95% CI, 0.05; 0.47]) remained associated with lower prevalence of epilepsy at inclusion. Among patients without epilepsy at baseline, 20.6% had new-onset epilepsy after five years. Baseline predictors of seizure occurrence included ruptured BAVM (HR 3.77 [95%CI 1.50; 9.44]) and surgery (HR 7.75, 95%CI, [2.04; 29.45]).

Conclusions

For patients with newly diagnosed BAVM, male gender, and frontal topography were baseline characteristics associated with a higher risk of epilepsy. Among patients without epilepsy, ruptured BAVM and surgery at baseline were predictors of epilepsy at five years follow-up.

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Keywords : BAVM, Epilepsy, Seizure, Surgery