Department of Neurosurgery, Inje University Hospital, Seoul, Korea.
J Clin Neurosci. 2002 May;9 Suppl 1:1-2.
This study was intended to investigate the pre- and postoperative profile of seizures in the patients with cerebral arteriovenous malformations (AVMs). The patients consisted of 46 consecutive cases with supratentorial AVMs operated on from May 1987 to May 1993. Their postoperative mean follow-up duration was 60 months. The overall incidences of seizure were 50% preoperatively and 52% postoperatively, and the incidence of intractable seizure was 15% in both pre- and postoperative period. The presence of preoperative seizure and large AVM size were significant indicators of high risk of postoperative seizures (P < 0.05). About 70% of the patients with preoperative seizures showed seizures postoperatively, while those without preoperative seizures developed seizures postoperatively in 35%. Regarding postoperative intractable seizures, 57% of the group with preoperative intractable seizures remained intractable postoperatively. In conclusion, removal of AVMs did not change the overall incidence of seizures, and patients with large sized AVMs and preoperative seizure had a higher possibility of postoperative seizures.
本研究旨在探讨脑动静脉畸形(AVM)患者术前和术后的癫痫发作情况。患者为 1987 年 5 月至 1993 年 5 月期间接受手术治疗的 46 例幕上 AVM 连续病例。他们的术后平均随访时间为 60 个月。总的癫痫发作发生率为术前 50%,术后 52%,术前和术后难治性癫痫发作的发生率均为 15%。术前癫痫发作和 AVM 体积大是术后癫痫发作风险高的显著指标(P<0.05)。约 70%的术前有癫痫发作的患者术后出现癫痫发作,而术前无癫痫发作的患者中有 35%术后出现癫痫发作。关于术后难治性癫痫发作,术前难治性癫痫发作组中有 57%的患者术后仍为难治性。总之,AVM 的切除并未改变癫痫发作的总体发生率,而体积较大的 AVM 和术前有癫痫发作的患者术后发生癫痫发作的可能性更高。