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Abstract：
OBJECTIVE: To evaluate seizure outcome in patients with seizure-associated dural arteriovenous fistulas (DAVFs).
METHODS: Between 2001 and 2019, 1198 consecutive patients underwent treatment for DAVFs in our neuroscience institute. Among these, 48 patients presented with initial seizure before treatment. The seizure outcome after treatment were assessed by patients\' medical records, updated clinical information, and, when necessary, direct patient contact.
RESULTS: Cortical venous reflux was present in all 48 patients with a history of seizure, including 36 cases with single fistula and 12 cases with multiple DAVFs. Complete angiographic occlusion of DAVFs was achieved in all patients at the latest follow-up. There were no immediate or long-term persistent complications after treatment. At 1-year follow-up, 54.2% (26/48) of the patients were seizure-free, and 29.2% (14/48) were medication-free. At 2-year follow-up, 81.3% (39/48) were seizure-free, and 64.6% (31/48) were medication-free. At the last follow-up (mean 7.9 years), 93.8% (45/48) were seizure-free, and 81.3% (39/48) were medication-free. Fewer than 5 seizures before treatment and a seizure history of <3 months before treatment were 2 independent predictive factors for higher seizure-free rate at 1-year follow-up (before P < 0.05) as well as independent predictive factors for higher medication-free rate at 2-year follow-up (both P < 0.05).
CONCLUSIONS: DAVF-related seizures can be effectively controlled through treatment of DAVF. Short seizure history and fewer seizures before treatment predict satisfactory seizure outcome after DAVF treatment, which indicates early treatment for seizure-associated DAVFs.
METHODS: Between 2001 and 2019, 1198 consecutive patients underwent treatment for DAVFs in our neuroscience institute. Among these, 48 patients presented with initial seizure before treatment. The seizure outcome after treatment were assessed by patients\' medical records, updated clinical information, and, when necessary, direct patient contact.
RESULTS: Cortical venous reflux was present in all 48 patients with a history of seizure, including 36 cases with single fistula and 12 cases with multiple DAVFs. Complete angiographic occlusion of DAVFs was achieved in all patients at the latest follow-up. There were no immediate or long-term persistent complications after treatment. At 1-year follow-up, 54.2% (26/48) of the patients were seizure-free, and 29.2% (14/48) were medication-free. At 2-year follow-up, 81.3% (39/48) were seizure-free, and 64.6% (31/48) were medication-free. At the last follow-up (mean 7.9 years), 93.8% (45/48) were seizure-free, and 81.3% (39/48) were medication-free. Fewer than 5 seizures before treatment and a seizure history of <3 months before treatment were 2 independent predictive factors for higher seizure-free rate at 1-year follow-up (before P < 0.05) as well as independent predictive factors for higher medication-free rate at 2-year follow-up (both P < 0.05).
CONCLUSIONS: DAVF-related seizures can be effectively controlled through treatment of DAVF. Short seizure history and fewer seizures before treatment predict satisfactory seizure outcome after DAVF treatment, which indicates early treatment for seizure-associated DAVFs.
摘要：
目的：评估癫痫相关的硬脑膜动静脉瘘（DAVFs）患者的癫痫转归。
方法：在2001年至2019年之间，我们的神经科学研究所连续有1198名患者接受了DAVF治疗。其中,48例患者在治疗前出现首次癫痫发作。治疗后的癫痫发作结果由患者病历评估，更新的临床信息，and,必要时,患者直接接触。
结果：所有48例有癫痫发作史的患者均存在皮质静脉回流，其中单瘘36例,多发DAVFs12例。在最新的随访中，所有患者均实现了DAVFs的完全血管造影闭塞。治疗后无即时或长期持续性并发症。在1年的随访中，54.2%(26/48)的患者无癫痫发作,29.2%(14/48)的患者不用药。在2年的随访中，81.3%(39/48)无癫痫发作，64.6%(31/48)为无药物治疗。在最后一次随访中（平均7.9年），93.8％（45/48）无癫痫发作，81.3%(39/48)为无药物治疗。治疗前小于5次癫痫发作和治疗前<3个月的癫痫发作史是1年随访时无癫痫发作率较高的2个独立预测因素(P<0.05前),也是2年随访时无药物治疗率较高的独立预测因素(均P<0.05)。
结论：DAVF治疗可有效控制DAVF相关性癫痫发作。短暂的癫痫发作史和治疗前癫痫发作次数较少预测DAVF治疗后癫痫发作结局满意。这表明癫痫相关的DAVF的早期治疗。
方法：在2001年至2019年之间，我们的神经科学研究所连续有1198名患者接受了DAVF治疗。其中,48例患者在治疗前出现首次癫痫发作。治疗后的癫痫发作结果由患者病历评估，更新的临床信息，and,必要时,患者直接接触。
结果：所有48例有癫痫发作史的患者均存在皮质静脉回流，其中单瘘36例,多发DAVFs12例。在最新的随访中，所有患者均实现了DAVFs的完全血管造影闭塞。治疗后无即时或长期持续性并发症。在1年的随访中，54.2%(26/48)的患者无癫痫发作,29.2%(14/48)的患者不用药。在2年的随访中，81.3%(39/48)无癫痫发作，64.6%(31/48)为无药物治疗。在最后一次随访中（平均7.9年），93.8％（45/48）无癫痫发作，81.3%(39/48)为无药物治疗。治疗前小于5次癫痫发作和治疗前<3个月的癫痫发作史是1年随访时无癫痫发作率较高的2个独立预测因素(P<0.05前),也是2年随访时无药物治疗率较高的独立预测因素(均P<0.05)。
结论：DAVF治疗可有效控制DAVF相关性癫痫发作。短暂的癫痫发作史和治疗前癫痫发作次数较少预测DAVF治疗后癫痫发作结局满意。这表明癫痫相关的DAVF的早期治疗。
