Work

Epilepsy Secondary to a Giant AVM: A Case Report

Year: 2025

Type: article

Abstract: Intracranial arteriovenous malformations (AVMs) are vascular anomalies that can present with intracranial hemorrhage, seizures, or neurological deficits. In this case, we present a woman with a giant right frontoparietal AVM (Spetzler-Martin Grade V) initially diagnosed after an intracerebral hemorrhage at Age 6. Surgical, endovascular, and radiosurgical treatments were not viable due to the lesion's size and eloquent location. Over time, the patient developed focal seizures, including catamenial patterns and left-arm spastic monoparesis. Initial antiseizure medications (ASMs) such as carbamazepine and phenytoin failed to provide adequate control at optimal dosage, with phenytoin exacerbating seizure frequency. Partial seizure control was eventually achieved with a combination of levetiracetam and carbamazepine. Neuroimaging showcases a large AVM, while EEG revealed focal epileptiform activity. This case illustrates the complexity of treating epilepsy secondary to giant AVMs, emphasizing the need for individualized ASM strategies and collaborative, multidisciplinary management.

Source: Case Reports in Vascular Medicine

DOI: 10.1155/crvm/5668999

Authors: Emilio García Gómez, Daniela Carolina Pimentel Saona, Juan Romero Valencia, Lenin Sandoval Luna, Cristobal Jeronimo Ortega Arenas, Daniel San-Juan

Institutions: Instituto Nacional de Neurología y Neurocirugía, Benemérita Universidad Autónoma de Puebla, Universidad Nacional Autónoma de México

Language: English

Topic: Epilepsy research and treatment

Subfield: Psychiatry and Mental health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $790