Accepted Manuscript Cerebral Arteriovenous Malformations and Epilepsy, Part 2: Predictors of Seizure Outcomes following Radiosurgery Dale Ding, M.D., Mark Quigg, M.D., M.Sc., F.A.N.A., Robert M. Starke, MD, M.Sc., Chun-Po Yen, M.D., Colin J. Przybylowski, B.S., Blair K. Dodson, B.S.N., Jason P. Sheehan, M.D., Ph.D. PII:

S1878-8750(15)00623-3

DOI:

10.1016/j.wneu.2015.04.064

Reference:

WNEU 2915

To appear in:

World Neurosurgery

Received Date: 15 January 2015 Revised Date:

23 April 2015

Accepted Date: 23 April 2015

Please cite this article as: Ding D, Quigg M, Starke RM, Yen C-P, Przybylowski CJ, Dodson BK, Sheehan JP, Cerebral Arteriovenous Malformations and Epilepsy, Part 2: Predictors of Seizure Outcomes following Radiosurgery, World Neurosurgery (2015), doi: 10.1016/j.wneu.2015.04.064. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

ACCEPTED MANUSCRIPT

Cerebral Arteriovenous Malformations and Epilepsy, Part 2: Predictors of Seizure Outcomes following

Dale Ding, M.D.1 Mark Quigg, M.D., M.Sc., F.A.N.A. 2

Chun-Po Yen, M.D.1

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Robert M. Starke, MD, M.Sc.1

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Radiosurgery

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Colin J. Przybylowski, B.S.3 Blair K. Dodson, B.S.N.1

Jason P. Sheehan, M.D., Ph.D.1

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University of Virginia

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Author addresses:

Department of Neurosurgery

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P.O. Box 800212

Charlottesville, VA 22908, United States University of Virginia

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2.

Department of Neurology P.O. Box 800394

Charlottesville, VA 22908, United States

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University of Virginia School of Medicine P.O. Box 800793

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Charlottesville, VA 22908, United States

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Corresponding Author Address: Jason Sheehan University of Virginia

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Department of Neurosurgery P.O. Box 800212

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Charlottesville, VA 22908 Voice 434-924-8129 Fax 434-243-6726

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Email [email protected]

Keywords: Epilepsy; Gamma Knife; Intracranial Arteriovenous Malformations; Neurologic Manifestations;

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Radiosurgery; Seizures; Vascular Malformations

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Short Title: Predictors of Seizure Outcomes following AVM Radiosurgery

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Abstract

Objective: Seizure outcomes following AVM management with radiosurgery remain incompletely understood. In

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this case-control study, we aim to determine the incidences and define the predictors of seizure improvement and de novo seizures in AVM patients with and without seizures at presentation, respectively.

Methods: We evaluated our institutional AVM radiosurgery database to determine the factors which were associated

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with favorable seizure outcome (seizure improvement or lack of de novo seizures). Seizure improvement was defined, in patients with seizures at presentation, as decreased seizure frequency or complete seizure remission. De

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novo seizures were defined, in patients without seizures at presentation, as new onset seizures following radiosurgery. Logistic regression analyses were performed to identify predictors of favorable seizure outcome.

Results: In the 229 patients with seizure presentation, the rates of seizure improvement and seizure remission were 57% and 20%, respectively. Prior AVM hemorrhage (P=0.015), longer follow-up (P