VASCULAR MALFORMATIONS AND EPILEPSY - CLINICAL CONSIDERATIONS AND BASIC MECHANISMS

Vascular malformations (VMs) are associated with epilepsy. The natural history of the various VMs, clinical presentation, and tendency to pr ovoke epilepsy determine treatment strategies. Investigations have pro bed the mechanisms of epileptogenesis associated with these lesions. E lectrophysiologic changes are associated with epileptogenic cortex adj acent to VMs. Putative pathophysiologic mechanisms of epileptogenesis include neuronal cell loss, glial proliferation and abnormal glial phy siology, altered neurotransmitter levels, free radical formation, and aberrant second messenger physiology.