Can a brain cavernoma be related to a seizure?
A cavernoma may be related to a seizure, but not every seizure is caused by one. How it is investigated, which tests are ordered, and when to call 911.
By Dr. Martin Roberto Casas MartínezNov 2, 20266 min read
In this article
- Why can a cavernoma cause a seizure?
- How can you tell whether the seizure is caused by the cavernoma and not something else?
- What tests might the care team review?
- Who takes part in the assessment, and what decisions are made?
- What to do during a seizure and when to call 911?
- Frequently asked questions
- What should I ask the neurologist and neurosurgeon?
- References
Summary: Yes, a cerebral cavernoma may be related to a seizure: in some people, its fragile-walled blood vessels leak blood and irritate nearby brain tissue, which can trigger a seizure. However, not every seizure is caused by a cavernoma. The care team investigates the connection by reviewing the medical history and conducting an electroencephalogram and imaging studies before determining follow-up.
When someone with a cerebral cavernoma (also called a cavernous malformation or cavernous angioma) has a seizure, the first question is whether the two are connected. They may be, but that connection is not assumed: it is investigated, and understanding that process can help you understand the tests and decisions that follow.
Why can a cavernoma cause a seizure?
A cavernoma is a cluster of small, tightly packed blood vessels with abnormally thin walls that occupies space inside the brain. These fragile walls may leak blood into the surrounding tissue, and irritation of that tissue can cause abnormal electrical discharges: a seizure.
A focal epileptic seizure occurs when abnormal electrical activity is limited to one area of the brain. It is often associated with areas where neurons are easily excited, for example, around a lesion. That is why the type of seizure and the location of the cavernoma are compared.
The symptoms of a focal seizure vary: abnormal movements of the head or a limb, tingling or other unusual sensations, seeing or hearing things that are not there, or episodes of impaired awareness.
How can you tell whether the seizure is caused by the cavernoma and not something else?
The team compares what happened during the seizure with the location of the cavernoma, reviews the electroencephalogram, and looks for signs of recent bleeding or other lesions on the MRI. If the area of the brain producing the seizure matches the location of the cavernoma, a connection is more likely; if they do not match, other causes are investigated.
Focal seizures can be caused by brain lesions of different origins, including a previous stroke, infections, trauma, or conditions present from birth. Having a cavernoma does not rule out another explanation, and attributing the seizure to it without investigating could leave the actual cause untreated.
The account of someone who witnessed the seizure is very valuable: how it started, which part of the body was affected first, and how long it lasted.
What tests might the care team review?
Common tests include an electroencephalogram (EEG), which records the brain’s electrical activity, and an MRI or CT scan to look for the cause of the seizure and assess the cavernoma. If you have previous MRI scans, the care team compares them with the new scan to look for changes.
An EEG may show where the abnormal activity starts, although a normal recording between seizures does not rule out the diagnosis. An MRI can show the cavernoma, its size, and whether there are signs of recent or older bleeding around it.
Who takes part in the assessment, and what decisions are made?
The assessment is collaborative: the neurologist (often a specialist in epilepsy) evaluates and treats the seizures, while the vascular neurosurgeon assesses the cavernoma and how it changes over time. Together, they decide whether to continue monitoring, adjust seizure treatment, or discuss options for the lesion.
Treatment for focal seizures includes medication and lifestyle changes, prescribed and adjusted by the neurologist; any changes are decided during a consultation.
Cavernomas are usually well-defined and can be removed with surgery, but surgery carries risks that depend on the lesion’s location. This option is discussed on a case-by-case basis, considering the relationship between the cavernoma and the seizures, as well as each person’s health.
What to do during a seizure and when to call 911?
Call 911 if the seizure lasts more than one minute, if the person does not wake up soon after the seizure, if another seizure occurs, or if sudden weakness on one side of the body, difficulty speaking, or a sudden, severe headache develops. These signs may indicate bleeding or another emergency.
During the seizure, keep the person away from objects they could hit and note the start time and how long it lasts. A first seizure in someone with a known cavernoma requires immediate medical assessment, not a scheduled appointment; in Mexico City, the appropriate route is 911 and an emergency department.
Frequently asked questions
Does having a seizure because of a cavernoma mean I have epilepsy?
Not necessarily. Epilepsy is a diagnosis made by a neurologist based on whether seizures recur, test results, and the risk of further seizures; a single seizure does not establish the diagnosis on its own. Ask your care team how they classify your case.
Does the seizure mean the cavernoma bled?
Not always. A seizure may result from irritation of nearby tissue without any clear evidence of recent bleeding. Comparing the MRI with previous scans can show whether there has been new bleeding or a change in the lesion.
Can I stop taking my antiseizure medication if I haven’t had a seizure in a while?
Not on your own. Stopping or reducing an antiseizure medication without medical guidance may cause more seizures. The decision is up to the neurologist, who considers how long you have been seizure-free, the EEG results, and the status of the cavernoma before recommending a change.
What should I ask the neurologist and neurosurgeon?
For a prolonged or repeated seizure, or one accompanied by weakness, difficulty speaking, or a sudden headache, call 911 first. For the collaborative assessment, bring your previous test results and a description of the seizure, and consider asking:
- •Does the area where my seizure started match the location of the cavernoma?
- •What did the MRI show compared with previous scans: was there bleeding or a change in size?
- •How will neurology and neurosurgery coordinate my follow-up, and whom should I notify if I have another seizure?
To prepare your questions, you can learn more about what a brain cavernoma is and prepare for your first consultation.
For non-urgent questions or to request an individual assessment, you can contact the office.
Informational notice: This content is for informational purposes and does not replace a medical consultation or constitute a diagnosis.
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