Kangmin He1, Shize Jiang1, Jianping Song1, Zehan Wu1, Liang Chen2, Ying Mao1. 1. Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China. 2. Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China. Electronic address: chenlianghs@126.com.
Abstract
OBJECTIVE: To evaluate the efficacy of surgery as a treatment for supratentorial cerebral cavernous malformation-associated epilepsy (SCCMAE) and determine the factors that influence outcomes. METHODS: During the 5-year period from 2005 to 2009, this study included 181 consecutive patients who were diagnosed with SCCMAE and surgically treated in a single institution. Each patient was followed up for at least 5 years postoperatively. A time-to-event analysis was performed using Kaplan-Meier curves and Cox regression models to evaluate the associated risk factors. RESULTS: The age at seizure onset was 30.6 ± 14.3 years, and the age at the time of surgery was 33.4 ± 14.6 years. The female/male ratio was 0.81:1. The mean diameter of the cerebral cavernous malformations (CCMs) was 2.0 cm. For CCMs involving eloquent brain areas, the CCM was removed with (in 14 cases) or without (in 28 lesions) the peripheral hemosiderin. None of the patients had long-term neurologic disabilities. An Engel class I outcome was achieved in 89.0%, 83.4%, 81.8%, and 80.1% of the patients after 6 months, 1 year, 2.5 years, and 5-years of follow-up, respectively. In patients who were class I after 1 year, the prevalence of seizure remission 5 years postoperatively was 96.0% (95% confidence interval, 94.4%-97.6%). CONCLUSIONS: This study supports the efficacy of using surgery to treat SCCMAE. A shorter duration of preoperative epilepsy was associated with better seizure control after surgery, and patient status at the 1-year follow-up was a reliable indicator of long-term Engel class I epilepsy control.
OBJECTIVE: To evaluate the efficacy of surgery as a treatment for supratentorial cerebral cavernous malformation-associated epilepsy (SCCMAE) and determine the factors that influence outcomes. METHODS: During the 5-year period from 2005 to 2009, this study included 181 consecutive patients who were diagnosed with SCCMAE and surgically treated in a single institution. Each patient was followed up for at least 5 years postoperatively. A time-to-event analysis was performed using Kaplan-Meier curves and Cox regression models to evaluate the associated risk factors. RESULTS: The age at seizure onset was 30.6 ± 14.3 years, and the age at the time of surgery was 33.4 ± 14.6 years. The female/male ratio was 0.81:1. The mean diameter of the cerebral cavernous malformations (CCMs) was 2.0 cm. For CCMs involving eloquent brain areas, the CCM was removed with (in 14 cases) or without (in 28 lesions) the peripheral hemosiderin. None of the patients had long-term neurologic disabilities. An Engel class I outcome was achieved in 89.0%, 83.4%, 81.8%, and 80.1% of the patients after 6 months, 1 year, 2.5 years, and 5-years of follow-up, respectively. In patients who were class I after 1 year, the prevalence of seizure remission 5 years postoperatively was 96.0% (95% confidence interval, 94.4%-97.6%). CONCLUSIONS: This study supports the efficacy of using surgery to treat SCCMAE. A shorter duration of preoperative epilepsy was associated with better seizure control after surgery, and patient status at the 1-year follow-up was a reliable indicator of long-term Engel class I epilepsy control.
Authors: Laurèl Rauschenbach; Pauline Bartsch; Alejandro N Santos; Annika Lenkeit; Marvin Darkwah Oppong; Karsten H Wrede; Ramazan Jabbarli; Witold X Chmielewski; Börge Schmidt; Carlos M Quesada; Michael Forsting; Ulrich Sure; Philipp Dammann Journal: Brain Behav Date: 2022-04-25 Impact factor: 3.405
Authors: Julia Velz; Martin Nikolaus Stienen; Marian Christoph Neidert; Yang Yang; Luca Regli; Oliver Bozinov Journal: Front Neurol Date: 2018-10-11 Impact factor: 4.003