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22-07-2022 | Stroke | Original Communication

Incidence and risk factors of epilepsy following brain arteriovenous malformation rupture in adult patients

Authors: Gonzague Guillaumet, Eimad Shotar, Frédéric Clarençon, Nader-Antoine Sourour, Kevin Premat, Stéphanie Lenck, Sophie Dupont, Alice Jacquens, Vincent Degos, Tom Boeken, Aurélien Nouet, Alexandre Carpentier, Bertrand Mathon

Published in: Journal of Neurology | Issue 12/2022

Abstract

Background

Little is known about incidence, time of onset, clinical presentation, and risk factors of epileptic seizure following brain arteriovenous malformation (bAVM) rupture.

Methods

We performed a monocentric retrospective cohort study from January 2003 to March 2021. The main objective of this study was to determine the incidence of seizures after spontaneous bAVM rupture in nonepileptic adult patients and describe the corresponding clinical features. The secondary objective was to identify clinical, radiological, or biological predictors for the occurrence of de novo seizures after bAVM rupture.

Results

Of the 296 cases of bAVM rupture registered during the study period, 247 nonepileptic patients (male 53%, median age 40) were included in the study. Fifty-nine patients (23.9%) had at least one seizure after bAVM rupture. The use of preventive antiepileptic drugs (10.3 [1.5–74.1]; P = 0.02) and decompressive craniectomy (15.4 [2.0–125]; P < 0.009) were independently associated with the occurrence of epilepsy after the bAVM rupture. The factors independently associated with the absence of any seizure after the rupture were isolated intraventricular hemorrhage (0.3 [0.1–0.99]; P = 0.04) and infratentorial location of the bAVM (0.2 [0.1–0.5]; P = 0.09). The first seizure occurred within the first year or within 5 years in, respectively, 83.1% and 98.3% of the patients.

Conclusions

Epilepsy affects nearly a quarter of patients after bAVM rupture. Decompressive craniectomy represents an independent risk factor significantly associated with the occurrence of epilepsy after bAVM rupture. The introduction of preventive AEDs after rupture could be considered in these most severe patients who have a decompressive craniectomy.

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Title: Incidence and risk factors of epilepsy following brain arteriovenous malformation rupture in adult patients
Authors: Gonzague Guillaumet
Eimad Shotar
Frédéric Clarençon
Nader-Antoine Sourour
Kevin Premat
Stéphanie Lenck
Sophie Dupont
Alice Jacquens
Vincent Degos
Tom Boeken
Aurélien Nouet
Alexandre Carpentier
Bertrand Mathon
Publication date: 22-07-2022
Publisher: Springer Berlin Heidelberg
Keywords: Stroke
Antiepileptic Drugs
Brain Arteriovenous Malformation
Epilepsy
Epileptic Seizure
Antiepileptic Drugs
Published in: Journal of Neurology / Issue 12/2022
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-022-11286-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Incidence and risk factors of epilepsy following brain arteriovenous malformation rupture in adult patients

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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