Seizures can occur in children with cerebral arteriovenous malformations (AVMs), increasing morbidity and complicating clinical care. The elements that cause seizures as a presenting sign, on the other hand, are not well understood. While there have been case reports of AVM-related attacks, the majority of research has focused on adults and included patients who had seizures following an AVM rupture. To do so, the researchers looked at AVMs’ demographic and anatomical aspects in a large group of kids. They used a single-center database to examine the demographic, clinical, and AVM morphological parameters of 189 pediatric patients. The effect of these variables on seizures as an initial presenting symptom in individuals with unruptured brain AVMs was investigated using univariate and multivariate logistic regression models.
In total, 28 of the 189 individuals had seizures at the start of the study (14.8%). Frontal lobe location (p = 0.02), greater AVM size (p = 0.003), older patient age (p = 0.04), and the Supplemented Spetzler-Martin (Supp-SM) grade (0.0006) were all shown to be linked to seizure manifestation in a univariate analysis. The presence of a frontal lobe AVM and a higher Supp-SM grade were verified by multivariate analysis. AVMs in the cortex or subcortical white matter were seen in all patients who had seizures. While some risk factors for seizure presentation were similar in children and adults, the risk factor profiles do not completely overlap. Seizures were more common in pediatric patients with cortical AVMs in the frontal lobe. Furthermore, the Supp-SM grade was strongly linked to seizure presentation. The effect of treatment approaches targeting AVMs on seizure management in these individuals should focus on future clinical studies.
Reference:thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/28/6/article-p663.xml
