Untreated Cerebral Cavernous Malformations: Risks and Rates of Seizures and Epilepsy

Clinical Takeaway

: Patients are unlikely to develop seizures after initial cerebral cavernous malformation presentation, but seizure recurrence rates are high and warrant treatment in those who experience a seizure before, during, or after diagnosis.

Context

Long-term risks and independent risk factors for seizures and epilepsy with untreated cerebral cavernous malformations (CCMs) remain unclear. In this prospective, population-based cohort study, researchers evaluated 300 adults diagnosed with a CCM by imaging or pathology. Outcomes included rates of seizures before, at the time of, and after initial CCM presentation, whether seizures recurred, and antiseizure medication (ASM) treatment over a 10-year period.

Key Results

One third of patients experienced a seizure at initial presentation.
Age reduced the risk of seizure occurrence by 18% per 10-year increment, whereas a seizure at initial CCM presentation increased seizure-recurrence risk about 13-fold.
Of 189 patients with no seizure hist…

Reviewing Author

Tanya J. W. McDonald, M.D., Ph.D.

Disclosures

Grant/Research SupportAmerican Epilepsy Society; American Heart Association