Earlier Age at Surgery for Brain Cavernous Angioma-Related Epilepsy May Achieve Complete Seizure Freedom without Aid of Anti-Seizure Medication
Background: The present study hypothesized that some factors may distinguish between patients with a brain cavernous angioma (BCA), who were free from anti-seizure medication (ASM), and patients who still required ASMs postoperatively. The purpose of the study was thus to identify factors associated...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-03-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/12/3/403 |
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| author | Ayataka Fujimoto Hideo Enoki Keisuke Hatano Keishiro Sato Tohru Okanishi |
| author_facet | Ayataka Fujimoto Hideo Enoki Keisuke Hatano Keishiro Sato Tohru Okanishi |
| author_sort | Ayataka Fujimoto |
| collection | DOAJ |
| description | Background: The present study hypothesized that some factors may distinguish between patients with a brain cavernous angioma (BCA), who were free from anti-seizure medication (ASM), and patients who still required ASMs postoperatively. The purpose of the study was thus to identify factors associated with ceasing ASMs for patients with drug-resistant epilepsy secondary to BCA, who underwent BCA removal surgery. Methods: We divided patients into those with drug-resistant epilepsy secondary to BCA who achieved complete seizure freedom without ASMs a year after surgery (No-ASM group) (International League Against Epilepsy (ILAE) classification class I with no epileptiform discharges), and others (ASM group) (ILAE classification ≤ II and/or epileptiform discharges). We statistically compared groups in terms of: (1) age at operation; (2) history of epilepsy; (3) size of BCA; and (4) location of BCA. Results: Overall, a year after the surgery, the No-ASM group comprised 12 patients (48%), and the ASM group comprised 13 patients (52%). In both multi- and univariate logistic regression analyses, age at BCA removal surgery correlated significantly with the No-ASM group (<i>p</i> = 0.043, <i>p</i> = 0.019), but history of epilepsy did not (<i>p</i> = 0.581, <i>p</i> = 0.585). Conclusions: Earlier age at surgery for patients with drug-resistant epilepsy is encouraged to achieve complete seizure freedom without the need for ASMs when the cause of epilepsy is BCA. |
| first_indexed | 2024-03-09T13:49:25Z |
| format | Article |
| id | doaj.art-b71f6c8a11c34844a4cb9510058685f1 |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-09T13:49:25Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-b71f6c8a11c34844a4cb9510058685f12023-11-30T20:54:16ZengMDPI AGBrain Sciences2076-34252022-03-0112340310.3390/brainsci12030403Earlier Age at Surgery for Brain Cavernous Angioma-Related Epilepsy May Achieve Complete Seizure Freedom without Aid of Anti-Seizure MedicationAyataka Fujimoto0Hideo Enoki1Keisuke Hatano2Keishiro Sato3Tohru Okanishi4Department of Neurosurgery, Seirei Hamamatsu General Hospital, Shizuoka 430-8558, JapanComprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Shizuoka 430-8558, JapanComprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Shizuoka 430-8558, JapanComprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Shizuoka 430-8558, JapanComprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Shizuoka 430-8558, JapanBackground: The present study hypothesized that some factors may distinguish between patients with a brain cavernous angioma (BCA), who were free from anti-seizure medication (ASM), and patients who still required ASMs postoperatively. The purpose of the study was thus to identify factors associated with ceasing ASMs for patients with drug-resistant epilepsy secondary to BCA, who underwent BCA removal surgery. Methods: We divided patients into those with drug-resistant epilepsy secondary to BCA who achieved complete seizure freedom without ASMs a year after surgery (No-ASM group) (International League Against Epilepsy (ILAE) classification class I with no epileptiform discharges), and others (ASM group) (ILAE classification ≤ II and/or epileptiform discharges). We statistically compared groups in terms of: (1) age at operation; (2) history of epilepsy; (3) size of BCA; and (4) location of BCA. Results: Overall, a year after the surgery, the No-ASM group comprised 12 patients (48%), and the ASM group comprised 13 patients (52%). In both multi- and univariate logistic regression analyses, age at BCA removal surgery correlated significantly with the No-ASM group (<i>p</i> = 0.043, <i>p</i> = 0.019), but history of epilepsy did not (<i>p</i> = 0.581, <i>p</i> = 0.585). Conclusions: Earlier age at surgery for patients with drug-resistant epilepsy is encouraged to achieve complete seizure freedom without the need for ASMs when the cause of epilepsy is BCA.https://www.mdpi.com/2076-3425/12/3/403epilepsycavernous angiomaanti-seizure medicationearly surgeryage at surgerymultifactorial mechanism |
| spellingShingle | Ayataka Fujimoto Hideo Enoki Keisuke Hatano Keishiro Sato Tohru Okanishi Earlier Age at Surgery for Brain Cavernous Angioma-Related Epilepsy May Achieve Complete Seizure Freedom without Aid of Anti-Seizure Medication Brain Sciences epilepsy cavernous angioma anti-seizure medication early surgery age at surgery multifactorial mechanism |
| title | Earlier Age at Surgery for Brain Cavernous Angioma-Related Epilepsy May Achieve Complete Seizure Freedom without Aid of Anti-Seizure Medication |
| title_full | Earlier Age at Surgery for Brain Cavernous Angioma-Related Epilepsy May Achieve Complete Seizure Freedom without Aid of Anti-Seizure Medication |
| title_fullStr | Earlier Age at Surgery for Brain Cavernous Angioma-Related Epilepsy May Achieve Complete Seizure Freedom without Aid of Anti-Seizure Medication |
| title_full_unstemmed | Earlier Age at Surgery for Brain Cavernous Angioma-Related Epilepsy May Achieve Complete Seizure Freedom without Aid of Anti-Seizure Medication |
| title_short | Earlier Age at Surgery for Brain Cavernous Angioma-Related Epilepsy May Achieve Complete Seizure Freedom without Aid of Anti-Seizure Medication |
| title_sort | earlier age at surgery for brain cavernous angioma related epilepsy may achieve complete seizure freedom without aid of anti seizure medication |
| topic | epilepsy cavernous angioma anti-seizure medication early surgery age at surgery multifactorial mechanism |
| url | https://www.mdpi.com/2076-3425/12/3/403 |
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