Timing of surgery on treating epilepsy caused by cavernomas_Journal of Epilepsy

Authors：

 ZHANGHeng ¹ , FANGYuan ¹ , CHENWenjing ¹ , LEIDing ¹ , CHENGJian ¹ , ZHOUDong ² , LIULing ² , YANBo ²

1. Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu 610041, China;
2. Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, China;

Corresponding author：

ZHANGHeng, Email: zhangheng.cn@gmail.com

Keywords：

Cavernomas; Epilepsy; Surgery; Prognosis; Classification

DOI：

10.7507/2096-0247.20150031

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Objective To evaluate the effect of the timing of surgery on treating refractory epilepsy caused by cavernomas. Method 63 patients with refractory epilepsy caused by intracranial supratentorial cavernomas were retrospectively analyzed on the duration of epilepsy, epileptogenesis sitations, and epileptic seizure types. After resection surgeries of cavernomas, the surgical outcomes were compared between the patients with shorter duration of seizures and the longer ones. Result The durations of epilepsy were beteen 3 months and 25 years, median 4.5 years. The temporal epilepsies were 43, frontal 12, parietal 3, occipital 1, cingulate gyrus 1, and multiple lobe 3. The overall ILAE class 1 outcome was 71.4% in 63 patients at 2-year-followup, and ILAE class 1 and 2 outcome was 81.6%. The seizure free rate in the group with epilepsy duration shorter than 5 years was 92.1%, better than the 56.0% in the group with epilepsy duration longer than 5 years. Conclusion Once the diagnosis of medical refractory epilepsy caused by cavernoma was confirmed, the early surgical operation should be considered seriously.

Citation： ZHANGHeng, FANGYuan, CHENWenjing, LEIDing, CHENGJian, ZHOUDong, LIULing, YANBo. Timing of surgery on treating epilepsy caused by cavernomas. Journal of Epilepsy, 2015, 1(3): 198-202. doi: 10.7507/2096-0247.20150031 Copy

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2.	Wieser HG, Blume WT, Fish D, et al. ILAE Commission Report. Proposal for a new classification of outcome with respect to epileptic seizures following epilepsy surgery. Epilepsia, 2001, 42(2):282-286.
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5.	Ryvlin P, Mauguiere F, Sindou M, et al.Interictal cerebtal metabolism and epilepsy and epilepsy in cavernous angiomas. Brain, 1995, 118(23):677-687.
6.	Moran NF, Fish DR, Kitchen N, et al.Supratentorial cavernous haemangiomas and epilepsy:a review of the literature and case series. Journal of Neurology Neurosurgery and Psychiatry, 1999, 66(5):561-568.
7.	Menzler K, Thiel P, Hermsen A, et al. The role of underlying structural cause for epilepsy classification:Clinical features and prognosis in mesial temporal lobe epilepsy caused by hippocampal sclerosis versus cavernoma. Epilepsia, 2011, 52(4):707-711.
8.	Ferroli P, Casazza M, Marras C, et al. Cerebral cavernomas and seizures:a retrospective study on 163 patients who underwent pure lesionectomy. Neurological Sciences, 2006, 26(6):390-394.
9.	Kivelev J, Niemela M, Kivisaari R, et al.Long-term outcome of patients with muliple cerebral cavernous malformations. Neurosurgery, 2009, 65(3):450-455.
10.	Rocamora R, Mader I, Zentner J, et al. Epilepsy surgery in patients with multiple cerebral cavernous malformations. Seizure-European Journal of Epilepsy, 2009, 18(4):241-245.
11.	Stavrou I, Baumgartner C, Frischer JM, et al. Long-term seizure control after resection of surpratentorial cavernomas:a retrospective single-centre study in 53 patients. Neurosurgery, 2008, 63(5):888-896.
12.	van Gompim JJ, Rubio J, Cascino GD, et al. Electrocorticography-guided resection of temporal cavernoma:is electrocorticography warranted and does it alter the surgical approach? Clinical article. Journal of Neurosurgery, 2009, 110(6):1179-1185.
13.	Stefan H, Hammen T. Cavernous haemangiomas, epilepsy and treatment strategies. Acta Neurologica Scandinavica, 2004, 110(6):393-397.
14.	Liscak R, Vladyka V, Simonova G, et al. Gamma knife surgery of brain cavernous hemangiomas. Journal of Neurosurgery, 2005, 102(18):207-213.
15.	Englot DJ, Han SJ, Lawton MT, et al. Predictors of seizure freedom in the surgical treatment of supratentorial cavernous malformations Clinical article. Journal of Neurosurgery, 2011, 115(6):1169-1174.
16.	Rydenhag B, Flink R, Malmgren K. Surgical outcomes in patients with epileptogenic tumours and cavernomas in sweden:good seizure control but late referrals. Journal of Neurology Neurosurgery and Psychiatry, 2013, 84(1):49-53.

1. von der Brelie C, Schramm J. Cerebral cavernous malformations and intractable epilepsy:the limited usefulness of current literature. Acta Neurochirurgica, 2011, 153(2):249-259.
2. Wieser HG, Blume WT, Fish D, et al. ILAE Commission Report. Proposal for a new classification of outcome with respect to epileptic seizures following epilepsy surgery. Epilepsia, 2001, 42(2):282-286.
3. Lüders. Textbook of Epilepsy Surgery. London, Informa Healthcare, 2008:479-487.
4. Schlamann M, Maderwald S, Becker W, et al. Cerebral cavernous hemangiomas at 7 Tesla:Initial experience. Academic Radiology, 2010, 17(1):3-6.
5. Ryvlin P, Mauguiere F, Sindou M, et al.Interictal cerebtal metabolism and epilepsy and epilepsy in cavernous angiomas. Brain, 1995, 118(23):677-687.
6. Moran NF, Fish DR, Kitchen N, et al.Supratentorial cavernous haemangiomas and epilepsy:a review of the literature and case series. Journal of Neurology Neurosurgery and Psychiatry, 1999, 66(5):561-568.
7. Menzler K, Thiel P, Hermsen A, et al. The role of underlying structural cause for epilepsy classification:Clinical features and prognosis in mesial temporal lobe epilepsy caused by hippocampal sclerosis versus cavernoma. Epilepsia, 2011, 52(4):707-711.
8. Ferroli P, Casazza M, Marras C, et al. Cerebral cavernomas and seizures:a retrospective study on 163 patients who underwent pure lesionectomy. Neurological Sciences, 2006, 26(6):390-394.
9. Kivelev J, Niemela M, Kivisaari R, et al.Long-term outcome of patients with muliple cerebral cavernous malformations. Neurosurgery, 2009, 65(3):450-455.
10. Rocamora R, Mader I, Zentner J, et al. Epilepsy surgery in patients with multiple cerebral cavernous malformations. Seizure-European Journal of Epilepsy, 2009, 18(4):241-245.
11. Stavrou I, Baumgartner C, Frischer JM, et al. Long-term seizure control after resection of surpratentorial cavernomas:a retrospective single-centre study in 53 patients. Neurosurgery, 2008, 63(5):888-896.
12. van Gompim JJ, Rubio J, Cascino GD, et al. Electrocorticography-guided resection of temporal cavernoma:is electrocorticography warranted and does it alter the surgical approach? Clinical article. Journal of Neurosurgery, 2009, 110(6):1179-1185.
13. Stefan H, Hammen T. Cavernous haemangiomas, epilepsy and treatment strategies. Acta Neurologica Scandinavica, 2004, 110(6):393-397.
14. Liscak R, Vladyka V, Simonova G, et al. Gamma knife surgery of brain cavernous hemangiomas. Journal of Neurosurgery, 2005, 102(18):207-213.
15. Englot DJ, Han SJ, Lawton MT, et al. Predictors of seizure freedom in the surgical treatment of supratentorial cavernous malformations Clinical article. Journal of Neurosurgery, 2011, 115(6):1169-1174.
16. Rydenhag B, Flink R, Malmgren K. Surgical outcomes in patients with epileptogenic tumours and cavernomas in sweden:good seizure control but late referrals. Journal of Neurology Neurosurgery and Psychiatry, 2013, 84(1):49-53.

Journal of Epilepsy

Timing of surgery on treating epilepsy caused by cavernomas

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