E-095 Partial embolization has no influence on epileptic seizures in patients with brain arteriovenous malformations

Abstract

Introduction Our study aimed to evaluate the influence of partial AVM embolization on the frequency and pattern of epileptic seizures and spontaneous hemorrhage risk. Materials and methods We performed retrospective analysis of demographics, AVM location and morphology, frequency and pattern of epileptic seizures as well as hemorrhage risks in 87 patients with cerebral AVMs who underwent partial endovascular treatment in single institution. The median follow-up period was 3 years (within range 1–6 years). The outcomes were evaluated using Engel scale. Results Median age was 36 years (within range 8–66 years), 60 patients were males and 27 were females. Distribution of AVMs in terms of Spetzler-Martin grade was the following: I – 2 patients (2.3%), II – 5 (5.7%), III – 29 (33.4%), IV – 32 (36.8%), V – 19 (21.8%). Of 87 patients there was no change in seizure pattern in 9 (10.3%) patients (Engel IVB class) and minor improvement in 7 (8.0%) patients (Engel class IVA). Among these 16 patients, 14 (87.5%) had frequent and very frequent seizures. The comparison of Engel class I patients versus all the rest patients revealed negative correlation (r=−0.44) between the volume of the occluded AVM and Engel class. Low frequency of seizures before embolization demonstrated weak negative correlation with Engel scale (r=−0.29) while very frequent seizures shown weak positive correlation with Engel scale (r=+0.25). There was no correlation between Engel scale and AVM grade and location, pre-operative pattern of seizures and type of embolic agent. There was no mortality. Perioperative complications occurred in 11 cases (12.6%) – 9 ischemic (10.3%) and 2 hemorrhagic (2.3%). There was total recovery after complications in 4 patients (4.6%) and mild neurological morbidity in 7 patients (8.0%). Seizures de novo occurred in 3.7%. Conclusion Partial AVM embolization does not worsen the course of secondary epilepsy and does not increase the risk of AVM rupture versus natural course. Disclosures A. Brusyanskaya: None. N. Strelnikov: None. A. Alshevskaya: None. K. Orlov: None.