Cavernous malformations and epilepsy: Medical management of seizures and the presurgical evaluation of medically intractable epilepsy

Introduction Cavernous malformations are common vascular malformations. Cavernomas are estimated to occur in about 0.5–0.7% of the population, although postmortem studies suggest the incidence may be even higher [1], and make up about 10–20% of intracranial vascular malformations [2]. Seizures are probably the most common presenting symptom [2, 3]. Although the majority of cavernomas may be clinically occult or detected as incidental findings, the frequent occurrence of these lesions means that they are a common cause of symptomatic epilepsy. It is difficult to accurately know the percentage of patients with cavernomas who have seizures because many patients may have asymptomatic cavernomas and do not seek medical attention. Treatment of seizures due to cavernomas is an important part of the management of patients with these lesions.