CONTROL OF EPILEPSY ASSOCIATED WITH CEREBRAL ARTERIOVENOUS-MALFORMATIONS AFTER RADIOSURGERY

Objective-To investigate the effect of radiosurgery for symptomatic ep ilepsy associated with cerebral arteriovenous malformations (AVMs). Me thods-Thirty five patients with unruptured epileptogenic AVMs were stu died with a mean follow up of 43.0 months. The duration of epilepsy be fore radiosurgery ranged from 2 months to 21 years (mean 2.8 years). F ifteen patients showed partial seizures; eight of these had associated secondary generalisation. The remaining 20 patients showed only gener alised seizures without preceding focal seizures. Results-At the final follow up examination, 28 patients remained seizure free, whereas sei zures continued in seven. Variables significantly associated with cont inuity of seizures after radiosurgery were the number of seizures befo re therapy (p < 0.01) and duration of epilepsy (p < 0.05). According t o Engel's classification, the 10 patients with intractable seizures be fore treatment included five with grade I, four with grade III, and on e with grade IV. The frequency of seizures began to decrease several m onths after radiosurgery; much shorter than the time required for morp hological change in the AVMs. Conclusions-Radiosurgery seems to be ben eficial for seizure control in patients with unruptured epileptogenic AVM.