title: Clinical outcome following medical treatment of cavernous malformation related epilepsy.
abstract: OBJECTIVE
  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).
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Yoonju
authors.initials: Y
authors.lastname: Lee
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Kyoo Ho
authors.initials: KH
authors.lastname: Cho
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hye Ihn
authors.initials: HI
authors.lastname: Kim
authors.affiliation: Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Seung-Koo
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Yang-Je
authors.initials: YJ
authors.lastname: Cho
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Kyoung
authors.initials: K
authors.lastname: Heo
authors.affiliation: Department of Neurology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Republic of Korea. Electronic address: bilee@paik.ac.kr.
authors.forename: Byung In
authors.initials: BI
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D004569:Electroencephalography; D004827:Epilepsy / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D020786:Hemangioma, Cavernous, Central Nervous System / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: Cavernous malformation; Epilepsy; Medical treatment