학술논문

Cavernoma‐related epilepsy: Review and recommendations for management—Report of the Surgical Task Force of the ILAE Commission on Therapeutic Strategies
Document Type
article
Source
Epilepsia. 54(12)
Subject
Epilepsy
Neurodegenerative
Brain Disorders
Neurosciences
Neurological
Anticonvulsants
Brain
Brain Neoplasms
Hemangioma
Cavernous
Central Nervous System
Humans
Neuroimaging
Risk Factors
Cavernous hemangioma
Epilepsy surgery
Etiology
Risk factors
Outcome
Surgical Task Force
Commission on Therapeutic Strategies of the ILAE
Clinical Sciences
Neurology & Neurosurgery
Language
Abstract
Cerebral cavernous malformations (CCMs) are well-defined, mostly singular lesions present in 0.4-0.9% of the population. Epileptic seizures are the most frequent symptom in patients with CCMs and have a great impact on social function and quality of life. However, patients with CCM-related epilepsy (CRE) who undergo surgical resection achieve postoperative seizure freedom in only about 75% of cases. This is frequently because insufficient efforts are made to adequately define and resect the epileptogenic zone. The Surgical Task Force of the Commission on Therapeutics of the International League Against Epilepsy (ILAE) and invited experts reviewed the pertinent literature on CRE. Definitions of definitive and probable CRE are suggested, and recommendations regarding the diagnostic evaluation and etiology-specific management of patients with CRE are made. Prospective trials are needed to determine when and how surgery should be done and to define the relations of the hemosiderin rim to the epileptogenic zone.