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Abstract Details

Early Surgery for Patients Presenting with Cavernous Malformations and Seizures
Epilepsy
P04 - (-)
199
BACKGROUND: Seizures are a common presentation for patients with supra-tentorial CMs. Surgical resection has been shown to be a successful treatment for patients with three or more preoperative seizures with 1 year seizure freedom rates approaching 65-70% (Baumann CR, Epilepsia 2007). There is little data that exists on post surgical outcomes in patients with only one or two pre-operative seizures.
DESIGN/METHODS: A database was created based on ICD-9 codes for all patients with supratentorial CMs over the last 10 years with at least one year postoperative follow up. We identified 37 patients who responded to a telephone survey. We divided the 37 patients into those with ? 2 or less and > 2 seizures. Our primary endpoint was seizure freedom at 1 year post-op.
RESULTS: Of the 37 patients, 18 patients had ? 2 or less pre-operative seizures. 17 of the 18 patients were seizure free at 1 year (total follow up years: mean 4.2, median 3.4, range 1-10) compared to 12 of the 19 patients with > 2 pre-operative seizures (total follow up years: mean 3.4, median 4.0, range 1-8; p=0.049, Fisher exact test). No late recurrence was seen in either group. The time to surgery from seizure onset was 5.7 months in the ? 2 preoperative seizure group and 22.2 months in group with > 2 seizures (p= 0.06).
CONCLUSIONS: Our results suggest that patients with fewer preoperative seizures who undergo early surgery for CM have a better postsurgical seizure outcome. Either disease duration or preoperative seizure frequency may impact response to surgical resection.
Authors/Disclosures

PRESENTER 		No disclosure on file
Manish Kapadia, MD No disclosure on file
Helmut Butzkueven, MD, MBBS Dr. Butzkueven has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Oxford Health Policy Forum. The institution of Dr. Butzkueven has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. The institution of Dr. Butzkueven has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck. The institution of Dr. Butzkueven has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. The institution of Dr. Butzkueven has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche. Dr. Butzkueven has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for MSBase . The institution of Dr. Butzkueven has received research support from NHMRC. The institution of Dr. Butzkueven has received research support from Biogen. The institution of Dr. Butzkueven has received research support from Roche. The institution of Dr. Butzkueven has received research support from Novartis.
No disclosure on file
Jeffrey D. Kennedy, MD (University of California, Davis) Dr. Kennedy has nothing to disclose.
Elizabeth Gerard, MD (Northwestern University) Dr. Gerard has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Xenon. The institution of Dr. Gerard has received research support from NIH/NINDS. The institution of Dr. Gerard has received research support from Xenon Pharmaceuticals. The institution of an immediate family member of Dr. Gerard has received research support from NIH. The institution of Dr. Gerard has received research support from Eisai, Inc. (via Stanford University). Dr. Gerard has received publishing royalties from a publication relating to health care.
Michael P. Macken, MD, MRCPI (Northwestern Medical Faculty Foundation) Dr. Macken has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jazz Pharma. Dr. Macken has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for UCB. Dr. Macken has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for SK LifeSciences. Dr. Macken has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for LivaNova. The institution of Dr. Macken has received research support from LivaNova.
No disclosure on file
No disclosure on file
Stephan Schuele, MD, FAAN (Northwestern Memorial Hospital) Dr. Schuele has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Monteris. Dr. Schuele has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Neurelis. Dr. Schuele has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for SK Life Science. Dr. Schuele has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Jazz. Dr. Schuele has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Clinical Neurophysiology. Dr. Schuele has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Thomas Needham. Dr. Schuele has received research support from National Institute of Health.