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Clinical outcome following medical treatment of cavernous malformation related epilepsy

Authors
 Yoonju Lee  ;  Kyoo Ho Cho  ;  Hye Ihn Kim  ;  Seung-Koo Lee  ;  Yang-Je Cho  ;  Kyoung Heo  ;  Byung In Lee 
Citation
 SEIZURE-EUROPEAN JOURNAL OF EPILEPSY, Vol.45(64) : 69, 2017 
Journal Title
 SEIZURE-EUROPEAN JOURNAL OF EPILEPSY 
ISSN
 1059-1311 
Issue Date
2017
MeSH
Adolescent ; Adult ; Anticonvulsants/therapeutic use* ; Electroencephalography ; Epilepsy/complications* ; Epilepsy/diagnostic imaging ; Epilepsy/drug therapy* ; Female ; Hemangioma, Cavernous, Central Nervous System/diagnostic imaging ; Hemangioma, Cavernous, Central Nervous System/drug therapy* ; Hemangioma, Cavernous, Central Nervous System/etiology* ; Humans ; Longitudinal Studies ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome* ; Young Adult
Keywords
Cavernous malformation ; Epilepsy ; Medical treatment
Abstract
PURPOSE: The study was conducted to assess the long-term outcome of antiepileptic drug (AED) treatment in drug-naïve patients with cavernous malformation (CM) related epilepsy (CRE). METHOD: This is a retrospective, single-center, long-term observational study of 34 patients with previously untreated seizures related to CM. All patients were followed-up for at least two years. Drug resistant epilepsy (DRE) was defined as two or more seizures per year after trial of two appropriate AEDs. Patients who had only one seizure during the previous one year were assigned as "epilepsy with rare seizures (ERSs)". RESULTS: Terminal 1-year seizure remission (1-YTR) was achieved in 22 (64.7%) patients, nine (26.5%) patients were diagnosed as DRE, and three (8.8%) patients were as ERSs. 1-YTR was achieved in 18 (52.9%) patients by the first drug regimen and in additional four (11.8%) patients by the second drug regimen. None of nine patients who failed to first two drug regimens did achieve 1-YTR. The location of CM in the temporal lobe was the only prognostic factor predicting a poor seizure outcome (p=0.012). CONCLUSION: The outcome of AEDs therapy in patients who were presented with new onset of CRE was quite comparable with that of patients with newly diagnosed epilepsy. Failure to achieve seizure-free after adequate trials of two AEDs seems appropriate as the criteria for their referral to surgical treatment. For patients with temporal lobe CRE, earlier presurgical evaluation may be considered justifiable once they failed to an adequate trial of the first drug.
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DOI
10.1016/j.seizure.2016.11.009
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Byung In(이병인)
Cho, Kyoo Ho(조규호) ORCID logo https://orcid.org/0000-0003-2402-7198
Cho, Yang Je(조양제)
Heo, Kyoung(허경)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/166156
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