Department of Neurology, Epilepsy Center Hessen, University Hospital and Philipps-University Marburg, Marburg, Germany.
Epilepsia. 2013 Dec;54(12):2025-35. doi: 10.1111/epi.12402. Epub 2013 Oct 17.
Cerebral cavernous malformations (CCMs) are well-defined, mostly singular lesions present in 0.4-0.9% of the population. Epileptic seizures are the most frequent symptom in patients with CCMs and have a great impact on social function and quality of life. However, patients with CCM-related epilepsy (CRE) who undergo surgical resection achieve postoperative seizure freedom in only about 75% of cases. This is frequently because insufficient efforts are made to adequately define and resect the epileptogenic zone. The Surgical Task Force of the Commission on Therapeutics of the International League Against Epilepsy (ILAE) and invited experts reviewed the pertinent literature on CRE. Definitions of definitive and probable CRE are suggested, and recommendations regarding the diagnostic evaluation and etiology-specific management of patients with CRE are made. Prospective trials are needed to determine when and how surgery should be done and to define the relations of the hemosiderin rim to the epileptogenic zone.
脑内海绵状血管畸形（CCMs）是一种明确的病变，多为单发，在人群中的发病率为 0.4%-0.9%。癫痫发作是 CCM 患者最常见的症状，对其社会功能和生活质量有重大影响。然而，接受手术切除的 CCM 相关性癫痫（CRE）患者仅有约 75%的术后达到无癫痫发作。这主要是因为未能充分努力来充分定义和切除致痫区。国际抗癫痫联盟（ILAE）治疗委员会的外科工作组和特邀专家对 CRE 的相关文献进行了回顾。建议了明确和可能的 CRE 的定义，并对 CRE 患者的诊断评估和病因特异性管理提出了建议。需要前瞻性试验来确定何时以及如何进行手术，并确定含铁血黄素环与致痫区的关系。
