Epilepsy risk and outcomes in brain arteriovenous malformations

Acute seizures and progression to epilepsy (chronic, recurrent seizures) is a common problem in patients with brain arteriovenous malformation (bAVM), which can cause significant disability contributing to poor quality of life. Effective seizure control (either freedom or improvement) after successful bAVM treatment has been reported in several studies; thus, unruptured bAVMs with epilepsy is considered an indication for intervention. Yet, the risk of seizures post-bAVM treatment remains high and there is significant variability in both reported practice and patient outcomes due to the lack of consensus and guidelines on anti-seizure medication (ASM) utilization, duration, and withdrawal after bAVM treatment. Significant gaps in knowledge remain regarding the risk of epilepsy and active epilepsy (treatment with ASM) in bAVM patients, and the rate of seizure control after bAVM treatment. 

The long-term objective of this project is to find the best epilepsy treatment options for bAVM patients to improve epilepsy outcomes and quality of life. This project leverages our UCSF cohort of bAVM patients to study the risk of epilepsy and outcomes before and after bAVM treatment, with a focus on outcomes and shared mechanisms between epileptogenesis and bAVM pathogenesis.