Abstracts

Rationale: Patients with cavernomas carry an estimated risk to develop seizures of 1.5-2.4%/patient/year. However, the risk factors for epileptic seizures in patients with supratentorial cavernomas remain controversial. Methods: In order to analyze the influence of the variables sex, age at operation, cortical involvement, archicortical (mesiotemporal) vs. neocortical involvement, side and lobar location of neocortical cavernomas, number of cavernomas, presence of an oedema, maximal diameter of the cavernomas and of the oedema, if present, on the occurrence of seizures, we analyzed retrospectively the clinical and MRI data of 76 consecutive patients with supratentorial cavernomas confirmed by neuropathology. A univariate logistic regression model was used for statistical evaluation. Results: Cortical involvement was significantly more often associated with seizures than a subcortical location of the cavernoma (P<0.0001). Furthermore, including only cavernomas with cortical involvement, epilepsy occurred more often in patients with archicortical than in patients with neocortical cavernomas (P<0.05). The lobar location of neocortical cavernomas was not significantly associated with an increased risk for seizures, nor were any of the other variables studied (P>0.05). Conclusions: We could show that the occurrence of seizures in patients with cavernomas is associated with cortical, especially archicortical (mesiotemporal) involvement of the cavernoma. Regarding cavernomas with neocortical involvement, lobar location was not significantly associated with epilepsy. This information is helpful in counseling patients with cavernomas regarding their risk of epileptic seizures.