THE RESULTS OF INVASIVE TREATMENT OF PATIENTS WITH BRAIN ARTERIOVENOUS MALFORMATIONS WITH SEIZURE
Alexey Leonidovich KRIVOSHAPKIN1,2,3, Kirill Yuryevich ORLOV1,2, Anna Sergeevna BRUSYANSKAYA1, Gleb Sergeevich SERGEEV3, Alexey Sergeevich GAYTAN2,3, Alexandr Evgenyevich SIMONOVICH2
1Federal State Budgetary Institution В«National Medical Research Center n.a. Academician E.N. Meshalkin» Ministry of Health of the Russian Federation
2Novosibirsk State Medical University of Minzdrav of Russia
3European Medical Center
Keywords: артериовенозная мальформация, структурная эпилепсия, нейрофизиологическое исследование, эпилептические приступы, ЭЭГ, arteriovenous malformation, structural epilepsy, seizure, neurophysiological study, EEG
Abstract
Purpose: to estimate influence of volume malformation on the course of structural epilepsy and neurophysiological data. Materials and methods: The study included 207 patients with brain AVM and seizure. 81 patients (pts) were performed by EEG before and after treatment. 103 patients underwent total invasive treatment, 96 pts - partial embolization and 8 pts - subtotal embolization. Follow up was 12 months. Evaluation of treatment was carried out on a scale Engel and ILAE. Results: Patients underwent a total treatment of grade I on the Engel scale were in 74.8 % (77 pts), and 1 grade on the ILAE scale were in 58.3 % (60 pts). Patients with a partial embolization of grade I on the Engel scale were in 40.4 % (42 pts), and 1 grade on the ILAE scale were in 20.2 % (21 pts), which is significantly worse than in the group with total treatment (on the Engel scale F = 5.1, ILAE - F = 5.8, р < 0.01). The subtotal embolization let get the grade I on the Engel scale in 62.5 % (5 pts). There was no significant difference to total treatment and partial embolization ( p > 0.05). By EEG investigated: epileptic and slow-wave activity, focus on the hemisphere, where AVM is localized, disorganization and diffuse changes in bioelectric activity (BA). The BA improvement was in 17.1 % pts in the total treatment group, and in partial embolization group - in 2.5 % pts. However, these data were not significant different ( p = 0.065). So, total treatment of brain AVMs gives the better control of seizure and more often improves EEG data.
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