Surgical treatment of symptomatic epilepsy in patients with brain cavernomas

Abstract

Introduction. Epileptic seizures are one of the most common clinical manifestations of brain cavernomas. The purpose of study is to assess the efficiency of symptomatic epilepsy surgical treatment in patients with cerebral cavernomas.Methods. The study included 22 patients with brain cavernomas caused symptomatic epilepsy. Patients were divided on two groups: I group consists 8 patients with cavernomas in the temporal lobe, II group consists 14 patients with extratemporal lesion’s localization. In all patients microsurgical resection of cavernomas was performed, 3 patients underwent additional anterior temporal lobectomy. Follow-up was from 10 months to 3,5 years.Results. In I group 5 (62.5%) patients became seizure-free or have rare seizures, in 3 (37,5%) cases seizure frequency reduced slightly or did not change. Control for seizures was most effective in patients who underwent topectomy with additional anterior temporal lobectomy. In group II seizure control or significant seizure reduction was achieved in 7 (50%) patients, in other 7 (50%) — seizure frequency reduced slightly or did not change.Conclusion. Surgical strategy of patients with symptomatic epilepsy associated with cavernomas should focus on the lesion resection with additional excision of the hemosiderin-stained tissue. In temporal cavernomas such surgery should be supplemented by anterior temporal lobectomy.