The outcome of antiepileptic drug (AED) therapy in people with epilepsy related to blood vessel malformation in the brain is similar to the outcome of  those with ‘general’ epilepsy, according to a study published in the scientific journal Seizure.According to the authors, failure to achieve seizure-freedom after the adequate trial of two AEDs seems an appropriate criterion for surgical referral of people with epilepsy related to blood vessel malformation. The researchers note, however, that in cases when blood vessel malformation is in the temporal lobe, earlier pre-surgical evaluation may be justifiable (once the first AED has failed).The study, conducted by scientists in the Republic of Korea, included 34 participants with epilepsy related to blood vessel malformation who had not previously been treated with an AED. Subjects were followed up for at least two years and their response to AED treatment was monitored  .Seizure remission for at least one year was achieved in 22 of the 34 people (64.7%). In 18 people (52.9%), this was following treatment with one AED, whilst in the remaining four it was following treatment with a second AED.Nine people (26.5%) failed to respond to both AEDs and were diagnosed with drug-resistant epilepsy. Finally, three people (8.8%) had only one seizure in the past year and were classed as having “epilepsy with rare seizures”.The location of the blood vessel malformation in the temporal lobe was the only factor that could predict poor seizure outcome. According to the authors, the location of the malformations and the probability that the epilepsy will be drug-resistant should be discussed with patients. The possibility of surgery should also be introduced.This study provides important information about the long-term clinical outcome of medical treatment of epilepsy related to blood vessel malformation.Author: Dr Özge Özkaya Click here for more articles about anti-epileptic drugs and pregnancy risks.