Microvascular anastomosis for the treatment of seizures in patients with cerebrovascular ischemia: a report of five cases.

The authors report five patients who had either generalized or focal seizures in association with occlusion of the internal carotid artery. Two of them developed a motor deficit after having had several seizures. The other three did not develop a fixed neurological deficit, but their seizures had continued in spite of anticonvulsant treatment. After an extracranial to intracranial (EC-IC) bypass, the seizures either stopped or became less frequent. Based on our experience with these patients and our review of the literature, we think that seizures may be the initial or at least an early manifestation of cerebrovascular insufficiency in some patients. An EC-IC bypass may be of help when angiographic evidence of cerebrovascular occlusive disease is found.