Features of the structure of epileptic syndrome and cognitive disorders in patients with cerebral arteriovenous malformation

Abstract

To assess the frequency, structure of epileptic syndrome and cognitive impairment in patients with cerebral AVM (PAVM). The main group consisted of 78 PAVM: average age of 36.2. The results of the study:1 subgroup- a right-hemisphere localization - 41(53%); 2 subgroup - a left-hemisphere localization – 37(47%). Of these, 33%frontal lobe; 12% the temporal lobe;17% area central convolutions; 28% the parietal and the occipital lobe;10% - subcortical structures. In all cases evaluated, the frequency of epileptic seizures: frequent 11%; moderate 50%; rare 28%; seizures were not observed in 11% cases. The structure of epileptic syndrome was presented in the following seizures: partial sensorimotor in 29%; vegetative-visceral - 40%; mixed: complex partial; secondary generalized - 31%. Changes in EEG in 14% cases, changes were not observed; moderate diffuse changes at the level of diencephalic structures –23%; paroxysmal activity of malformations with an interest in diencephalic structures of the brain-41%;the formation of a mirror focus –10%, moderate irritative changes of EEG –7%; the presence of the pattern of epileptiform activity-5%. Cognitive impairment of varying severity degree were identified in PAVM: mild cognitive disorders – 21%; mild cognitive impairment – 64%; dementia from mild to severe, severity – 13%. The duration and frequency of the epileptic syndrome of the complex structure aggravate the course of cognitive impairment, thereby reducing quality of life of PAVM. A comprehensive assessment of cognitive disorders, structure and frequency of epileptic syndrome can be a diagnostic criterion of the results of the immediate outcomes of endovascular treatment of AVM.