Postoperative seizure outcome in a series of 114 patients with supratentorial arteriovenous malformations

The incidence of de novo and ongoing postoperative seizures and factors imp licated in an increased likelihood of seizures following supratentorial cer ebral arteriovenous malformation (AVM) resection remain controversial. We i nvestigated the frequency, severity and Variables associated with postopera tive seizures in 114 consecutive patients who underwent complete surgical e xcision of supratentorial AVMs at our institution. The minimal follow up pe riod was 24 months. The incidence of seizures post-AVM surgery was 21% (les s than half that found preoperatively). The incidence of postoperative seiz ures first manifesting >12 months post-AVM resection was 6.3%. A history of preoperative seizures was associated with an increased likelihood of multi ple (greater than or equal to 4) seizures >1 month post-AVM resection (chi( 2) = 4.38, P = 0.04). Poor functional neurological outcome at 12 months was also a risk factor for the development of greater than or equal to 1 posto perative seizure using logistic regression analysis (P = 0.04, odds ratio 1 .52, 95% Cl 1.01-2.28). Cessation of AED therapy in all patients who remain seizure-free at 12 months post-AVM resection is appropriate due to a low r isk of new seizure onset or seizure recurrence. (C) 2000 Harcourt Publisher s Ltd.