Apparently diffuse epileptic abnormalities caused by a small cavernous malformation: A surgical case report

Abstract

Resective surgery is considered if the lesion location is concordant with the epileptogenic zone evaluated by electrophysiological assessment. Diffuse epileptic abnormalities may lead to extended resection or preclude an indication for surgical treatment. We report a 17-year-old boy with a small cavernous malformation presenting drug-resistant epilepsy. Although pre-surgical evaluations revealed epileptic abnormalities widely around the lesion, and invasive evaluation with implanted subdural electrodes failed to localize seizure onset to the lesion, his seizures were significantly improved after simple lesionectomy. A small cavernous malformation could cause apparently diffuse functional abnormalities, and simple lesionectomy may be a reasonable option for drug-resistant epilepsy associated with a cavernous malformation.