Postoperative seizure outcome in a series of 114 patients with supratentorial arteriovenous malformations.
The incidence of de novo and ongoing postoperative seizures and factors implicated in an increased likelihood of seizures following supratentorial cerebral arteriovenous malformation (AVM) resection remain controversial. We investigated the frequency, severity and variables associated with postoperative seizures in 114 consecutive patients who underwent complete surgical excision of supratentorial AVMs at our institution. The minimal follow up period was 24 months. The incidence of seizures post-AVM surgery was 21% (less than half that found preoperatively). The incidence of postoperative seizures first manifesting >12 months post-AVM resection was 6.3%. A history of preoperative seizures was associated with an increased likelihood of multiple (> or =4) seizures >1 month post-AVM resection (chi2 = 4.38, P = 0.04). Poor functional neurological outcome at 12 months was also a risk factor for the development of > or =1 postoperative seizure using logistic regression analysis (P = 0.04, odds ratio 1.52, 95% CI 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 risk of new seizure onset or seizure recurrence.
Thorpe
M L
ML
Department of Neurology, Royal North Shore Hospital, St Leonards, NSW, Australia.
Cordato
D J
DJ
Morgan
M K
MK
Herkes
G K
GK
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D016009:Chi-Square Distribution; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000150:complications; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D019635:Neurosurgical Procedures / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications; D012044:Regression Analysis; D012307:Risk Factors; D012640:Seizures / Q000188:drug therapy / Q000209:etiology*; D013375:Substance Withdrawal Syndrome; D013997:Time Factors
D000927:Anticonvulsants