Quality of life after radiosurgery for cerebral arteriovenous malformation patients who present with seizure

• Published in: European journal of neurology Vol. 19; no. 7; pp. 984 - 991
• Main Authors: Yang, S.-Y., Paek, S. H., Kim, D. G., Chung, H.-T.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-07-2012; John Wiley & Sons, Inc
• Subjects: Adult; arteriovenous malformation; cerebral; Cerebral blood flow; Diagnosis, Differential; Employment; Female; Follow-Up Studies; Humans; Intracranial Arteriovenous Malformations - diagnosis; Intracranial Arteriovenous Malformations - epidemiology; Intracranial Arteriovenous Malformations - surgery; Inventories; Male; Middle Aged; Quality of life; Quality of Life - psychology; radiosurgery; Radiosurgery - psychology; seizure; Seizures; Seizures - diagnosis; Seizures - epidemiology; Seizures - surgery; Surveys and Questionnaires; Treatment Outcome; Young Adult
• ISSN: 1351-5101; 1468-1331
• DOI: 10.1111/j.1468-1331.2012.03664.x

Background and purpose:  This study assessed the quality of life (QOL) and employment status after radiosurgery for arteriovenous malformation (AVM) patients who presented with seizure.
Methods:  Between 1997 and 2006, 78 AVM patients who presented with seizure and received radiosurgery were assessed using serial imaging tests, clinical evaluations that included employment status, and a QOL survey. The QOL questionnaire was developed as a retrospective screening tool to estimate the present QOL and the patient’s self‐rated relative changes (trend values) in QOL after radiosurgery. These results were correlated to one another using the Engel seizure frequency scoring system.
Results:  The follow‐up periods ranged from 48.0 to 151.0 months (mean, 92.5). The mean trend values and mean QOL scores in patients with seizure freedom or AVM obliteration were significantly greater than in patients without these outcomes (all P values < 0.05). Good radiosurgical outcomes were associated with attaining employment (all P values < 0.05). However, differences in employment status were not significant (P = 0.186) despite a higher proportion of patients who described their workplace activity as improved compared with their pre‐radiosurgical activity at the last follow‐up evaluation.
Conclusions:  Radiosurgery may improve QOL and employment status in AVM patients, especially patients who experience seizure freedom or AVM obliteration.