ArticleNeurology2025
Seizures and Epilepsy in Patients With Untreated Cerebral Cavernous Malformations: A Prospective, Population-Based Cohort Study.
Article in Neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
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6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesTreatment decisions for patients with epileptic seizures due to cerebral cavernous malformations (CCMs) are challenging because of a paucity of studies. We aimed to assess the rates and risk factors of CCM-related seizures during long-term follow-up without CCM intervention.
methodsThis population-based study included people aged 16 years or older in Scotland who were newly diagnosed with CCM during 1999-2003 or 2006-2010, using brain MRI or pathology. From the initial presentation that led to CCM diagnosis, during prospective follow-up without CCM intervention, we analyzed the rates and risk factors for epileptic seizure(s) after any presentation, a first-ever epileptic seizure, seizure recurrence after a first unprovoked epileptic seizure, and 2-year/5-year seizure freedom among patients with CCM-related epilepsy (CRE).
resultsWe included 300 patients with CCM (median age 44 years, interquartile range [IQR] 32-57, 159 [53%] female). During a median follow-up of 15 years (IQR 8-20), 98 (33%) patients experienced epileptic seizure(s) after any presentation, which was associated with age (adjusted hazard ratio [aHR] 0.82, 95% CI 0.71-0.95, per 10-year increment, DISCUSSION: The risk of a first-ever epileptic seizure from CCM is low. Four of 5 patients who experience a first unprovoked epileptic seizure develop a recurrent seizure within 10 years, justifying diagnosis of CRE after a first unprovoked epileptic seizure due to CCM. Most of the patients with CRE achieve 2-year/5-year seizure freedom within 10 years. These long-term findings can inform patients and guide clinical practice.
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