Prevalence of Arteriovenous Malformation (AVM) in Idiopathic Generalized Seizures (IGS) Using Digital Subtraction Angiography (DSA)

Objectives: Study prevalence of Arteriovenous malformation (AVM) in Apparently Idiopathic Generalized seizures (IGS) using Digital subtraction angiography (DSA). Materials and Methods: It is Prospective study along 20 cases of IGS seizures. All patients underwent, Clinical examination, Full Lab. Investigations, EEG, MRI brain, MRA brain, Diagnostic Digital subtraction angiography (DSA). Results: As regard types of generalized seizures, ten (50%) cases were generalized tonic clonic seizures, six (30%) cases were myoclonic seizures and four (20%) cases were absence seizures. For the twenty cases 16 cases (80%) showed generalized poly spikes and slow waves seen along all leads (Paroxysm of spikes and slow waves) on the other hand EEG showed unilateral persistent spikes for 4 cases (20%) of cases with secondary late polyspike at all leads, on the other side corresponding MRI brain, MRA and MRV are completely normal in all cases. As regard DSA showed micro AVMs in 4 CASES (20%) cases (3 superficial right temporal, one superficial left parietal).Correlation between DSA findings and EEG findings, EEG spikes were seen at same side of corresponding Micro AVMS recorded by DSA. Conclusion: Patients of Idiopathic generalized seizures with EEG with Focal persistent spikes and Normal MRI, MRA and MRV brain showed be further investigated with DSA for possibility of micro-vascular AVM changing the diagnosis and prognosis from idiopathic generalized to focal seizures with different management and prognosis too, answering the question is this truly idiopathic generalized seizures or not?

Author(s):  Mohamed Hamdy

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