Postoperative Seizure Outcomes In A Series Of 49 Patients With Brain Arteriovenous Malformations Associated With Seizures

OBJECTIVE:A series of 49 postoperative patients with brain arteriovenous malformations associated with seizures between 1999 and 2003 were retrospectively analyzed. Their characteristics of epidemiology, clinical characteristics, surgical operations and seizure outcomes were assessed. METHODS: Collected data of patients with brain arteriovenous malformations associated with seizures between January 1999 and January 2003 were analyzed. As determined with the Engel Seizure Outcome Scale, we assessed the seizure outcomes of these patients via clinical follow-up monitoring. All these patients were classified into two groups by the seizure outcome of Classâ… (free of disabling seizures): Groupâ… were free of disabling seizures and Groupâ…¡were the others. We compared the following factors: sex, age, side, AVMs location, occurrence of intracranial hemorrhage, AVMs diameter, Venous drainage, Classification of Spetzler-Martin, seizure type, duration of seizure history, preoperative radiosurgery, duration of operation time, opened ventricle, Bipolar-coagulation, and intracranial infection. We tested for statistical associations between these factors and seizure outcomes. RESULTS: None of operative patients were dead. The seizure outcomes were satisfactory. As determined with the Engel Seizure Outcome Scale, there were 31 (63.3%) Class I (free of disabling seizures), 11 (22.45%) Class II (rare disabling seizures), 5 (10.2%) Class III (worthwhile improvement), and 2 (4.08%) Class IV (no worthwhile improvement) outcomes. The seizures of 42(86%) patients were controlled very well. All the variables were not associated with Class I outcomes. Probably, the Bipolar-coagulation was statistically associated with Class I outcomes. CONCLUSION: Surgical operation was an effective treatment of brain arteriovenous malformations associated with seizures. The mortality was less than 1%. The seizures of 86% patients can be controlled well by operation. The assured factors affecting the seizure outcomes were not be founded. Maybe the Bipolar-coagulation during the operation was an effective method to control the seizures.