<<snip>>
The iron and the hemosiderin deposits induce metabolic perturbations
and tissue reorganization (gliosis and sclerosis) around the
cavernoma. These cortical modifications seem to be responsible for the
epileptic discharges but this is difficult to demonstrate.
<<snip>>

Neurochirurgie. 2007 Jun;53(2-3 Pt 2):156-62. Links
[Epileptogenicity and evaluation of epileptic risk][Article in French]

Mauguière F.
Service de neurologie fonctionnelle et d'épileptologie, hôpital
neurologique, groupement hospitalier Est, hospices civils de Lyon
(HCL), 59 boulevard Pinel 69394, Lyon cedex 03, France. mauguier@univ-
lyon1.fr

Epilepsy is the more frequent clinical manifestation of hemispheric
cavernomas in 50 to 75% of symptomatic cases; the annual risk of a
first seizure is evaluated from 1.5 to 2.5%. As for all epileptogenic
lesions, many questions arise: Is the pathologic tissue or the
perilesional cortex responsible for the epileptic symptoms? Is the
risk related with the topography of the lesion? Is the prognosis of
the epilepsy related with the number of seizures? Can the epilepsy
become drug-resistant? Can surgical treatment cure the epilepsy? When
surgery is indicated, should lesionectomy alone or lesionectomy plus
perilesional tissue resection be performed? The iron and the
hemosiderin deposits induce metabolic perturbations and tissue
reorganization (gliosis and sclerosis) around the cavernoma. These
cortical modifications seem to be responsible for the epileptic
discharges but this is difficult to demonstrate. Epileptic discharges
have been recorded in the perilesional tissue in only one study of the
literature. Drug therapy can usually control the seizures, but it
appears that surgery is more effective when the epilepsy is recent and
the seizures are not too frequent. For these reasons it would appear
licit to propose the resection of the lesion when the surgical risk is
not too great. In case of drug-resistant epilepsy, the same function-
targeted surgical strategy may be used as for the management of any
severe epilepsy.

PMID: 17507046 [PubMed - in process]

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