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Epilepsy and Arachnoid Cysts

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Arachnoid Cysts

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Abstract

Arachnoid cysts (ACs) can be associated with epilepsy. The true prevalence and incidence of this association can’t be determined because imaging is not systematically performed in all epilepsy types and is not always available. The relationship between epilepsy and ACs is a matter of debate. For some authors, ACs should be considered incidental. Others suggest a possible causal relationship based on the favorable outcome of epilepsy after cyst surgery in some studies. Many factors have been proposed as possible mechanisms of epileptogenesis in ACs such as compression, increased level of excitatory amino acids within the cystic fluid, alteration of blood perfusion in the surrounding cortex, or the association with parenchymal lesions. Different types of seizures were reported in association with ACs, mainly focal in nature. The majority of ACs are located within the middle cranial fossa; however, most studies suggest that they may not be related to a specific seizure type and electroencephalographic (EEG) focus. The first step in the diagnostic workup should be to classify as accurately as possible the type of seizure and the epileptic syndrome. Cases can then be classified into three groups. The first group comprises the epileptic syndromes that are traditionally not associated with lesions such as idiopathic generalized epilepsy whereby the AC is probably incidental. In the second group, AC is associated with other lesions that are known to cause epilepsy. Electroclinical and imaging correlation should be reviewed to confirm whether the AC or the associated abnormality causes the seizures. Video EEG, positron emission tomography (PET), or single-photon emission computed tomography (SPECT) can be performed to detect the epileptogenic focus. The third group comprises cases where there are neither associated brain lesions on magnetic resonance imaging nor criteria for a nonlesional epileptic syndrome. Video EEG, PET, or SPECT may help localize the seizure focus. When it is near the AC, intraoperative corticography or intracranial EEG recording might be required to localize an abnormality in the surrounding cortex. There is currently no consensus regarding the choice of treatment or the ideal technique when surgery is considered. Management should be performed by a multidisciplinary team. There is an urgent need for prospective multicentric studies pooling the accumulated data from multiple institutions to obtain a large sample size that would allow the study of the relationship of AC to epilepsy, treatment indications, the most suitable surgical technique when surgery is considered, and the clinical outcome.

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References

  1. Armon C, Radtke RA, Friedman AH, Dawson DV. Predictors of outcome of epilepsy surgery: multivariate analysis with validation. Epilepsia. 1996;37(9):814–21. https://doi.org/10.1111/j.1528-1157.1996.tb00033.x.

    Article  CAS  PubMed  Google Scholar 

  2. Arroyo S, Santamaria J. What is the relationship between arachnoid cysts and seizure foci? Epilepsia. 1997;38(10):1098–102. https://doi.org/10.1111/j.1528-1157.1997.tb01199.x.

    Article  CAS  PubMed  Google Scholar 

  3. Blauen A, Stutterd CA, Stouffs K, Dumitriu D, Deggouj N, et al. Chudley-McCullough syndrome: a recognizable clinical entity characterized by deafness and typical brain malformations. J Child Neurol. 2021;36(2):152–8. https://doi.org/10.1177/0883073820960314.

    Article  PubMed  Google Scholar 

  4. Boronat S, Barber I. Less common manifestations in TSC. Am J Med Genet C Semin Med Genet. 2018;178(3):348–54. https://doi.org/10.1002/ajmg.c.31648.

    Article  PubMed  Google Scholar 

  5. Couvreur T, Hallaert G, Van Der Heggen T, Baert E, Dewaele F, et al. Endoscopic treatment of temporal arachnoid cysts in 34 patients. World Neurosurg. 2015;84(3):734–40. https://doi.org/10.1016/j.wneu.2015.04.053.

    Article  PubMed  Google Scholar 

  6. D’Angelo V, Gorgoglione L, Catapano G. Treatment of symptomatic intracranial arachnoid cysts by stereotactic cyst-ventricular shunting. Stereotact Funct Neurosurg. 1999;72(1):62–9. https://doi.org/10.1159/000029672.

    Article  PubMed  Google Scholar 

  7. Del Brutto OH, Mera RM, Kiernan J, Castle P, Zambrano M, Sedler MJ. Supratentorial arachnoid cysts and seizures/epilepsy: a population study in community dwellers aged ≥20 years. Epilepsia. 2019;60(8):e83–7. https://doi.org/10.1111/epi.16287.

    Article  PubMed  Google Scholar 

  8. Di Rocco C, Tamburrini G. Arachnoid cysts. In: Shorvon SD, Andermann F, Guerrini R, editors. The causes of epilepsy: common and uncommon causes in adults and children. Cambridge: Cambridge University Press; 2019. p. 341–5. https://doi.org/10.1017/CBO9780511921001.053.

    Chapter  Google Scholar 

  9. Ergün R, Ökten Aİ, Gezercan Y, Gezici AR. Sturge-Weber syndrome accompanied with multiple congenital intracranial lesions. Acta Neurochir. 2007;149(8):829–30. https://doi.org/10.1007/s00701-007-1224-z.

    Article  PubMed  Google Scholar 

  10. Fisher RS, Cross JH, French JA, Higurashi N, Hirsch E, et al. Operational classification of seizure types by the International League Against Epilepsy: position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58(4):522–30. https://doi.org/10.1111/epi.13670.

    Article  PubMed  Google Scholar 

  11. Fuchs F, Moutard ML, Blin G, Sonigo P, Mandelbrot L. Prenatal and postnatal follow-up of a fetal interhemispheric arachnoid cyst with partial corpus callosum agenesis, asymmetric ventriculomegaly and localized polymicrogyria. Fetal Diagn Ther. 2008;24(4):385–8. https://doi.org/10.1159/000165511.

    Article  CAS  PubMed  Google Scholar 

  12. Furune S, Negoro T, Maehara M, Nomura K, Miura K, et al. Magnetic resonance imaging in complex partial seizures. Psychiatry Clin Neurosci. 1989;43(3):361–7. https://doi.org/10.1111/j.1440-1819.1989.tb02927.x.

    Article  CAS  Google Scholar 

  13. Gan YC, Connolly MBC, Steinbok P. Epilepsy associated with a cerebellar arachnoid cyst: seizure control following fenestration of the cyst. Childs Nerv Syst. 2008;24(1):125–34. https://doi.org/10.1007/s00381-007-0439-x.

    Article  PubMed  Google Scholar 

  14. Gosalakkal JA. Intracranial arachnoid cysts in children: a review of pathogenesis, clinical features, and management. Pediatr Neurol. 2002;26(2):93–8. https://doi.org/10.1016/s0887-8994(01)00329-0.

    Article  PubMed  Google Scholar 

  15. Hajek M, Do KQ, Duc C, Boesiger P, Wieser HG. Increased excitatory amino acid levels in brain cysts of epileptic patients. Epilepsy Res. 1997;28(3):245–54. https://doi.org/10.1016/s0920-1211(97)00050-8.

    Article  CAS  PubMed  Google Scholar 

  16. Helland CA, Wester K. A population-based study of intracranial arachnoid cysts: clinical and neuroimaging outcomes following surgical cyst decompression in children. J Neurosurg Pediatr. 2006;105(5):385–90. https://doi.org/10.3171/ped.2006.105.5.385.

    Article  Google Scholar 

  17. Holst AV, Danielsen PL, Juhler M. Treatment options for intracranial arachnoid cysts: a retrospective study of 69 patients. Acta Neurochir Suppl. 2012;114:267–70. https://doi.org/10.1007/978-3-7091-0956-4_52.

    Article  PubMed  Google Scholar 

  18. Hoyt AT, LaViolette PS, Lew SM. Fibrin sealant to prevent subdural electrode migration during intracranial electroencephalographic monitoring in a patient with a large arachnoid cyst. J Neurosurg Pediatr. 2014;14(1):115–9. https://doi.org/10.3171/2014.3.PEDS13489.

    Article  PubMed  Google Scholar 

  19. Huang YH, Yang TM, Lin YJ, Tsai NW, Lin WC, et al. Risk factors and outcome of seizures after chronic subdural hematoma. Neurocrit Care. 2011;14(2):253–9. https://doi.org/10.1007/s12028-011-9509-8.

    Article  PubMed  Google Scholar 

  20. Jiménez-Genchi A, Díaz-Galviz JL, García-Reyna JC, Avila-Ordoñez MU. Coexistence of epileptic nocturnal wanderings and an arachnoid cyst. J Clin Sleep Med. 2007;3(4):399–401.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Kawamura T, Morioka T, Nishio S, Fukui K, Yamasaki R, Matsuo M. Temporal lobe epilepsy associated with hippocampal sclerosis and a contralateral middle fossa arachnoid cyst. Seizure. 2002;11(1):60–2. https://doi.org/10.1053/seiz.2001.0564.

    Article  PubMed  Google Scholar 

  22. Kim H, Kim DW, Lee ST, Byun JI, Seo JG, et al. Antiepileptic drug selection according to seizure type in adult patients with epilepsy. J Clin Neurol. 2020;16(4):547–55. https://doi.org/10.3988/jcn.2020.16.4.547.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Koch CA, Moore JL, Voth D. Arachnoid cysts: how do postsurgical cyst size and seizure outcome correlate? Neurosurg Rev. 1998;21(1):14–22. https://doi.org/10.1007/BF01111480.

    Article  CAS  PubMed  Google Scholar 

  24. Koch CA, Voth D, Kraemer G, Schwarz M. Arachnoid cysts: does surgery improve epileptic seizures and headaches? Neurosurg Rev. 1995;18(3):173–81. https://doi.org/10.1007/BF00383722.

    Article  CAS  PubMed  Google Scholar 

  25. Kushen MC, Frim D. Placement of subdural electrode grids for seizure focus localization in patients with a large arachnoid cyst. Neurosurg Focus. 2007;22(2):1–3. https://doi.org/10.3171/foc.2007.22.2.5.

    Article  Google Scholar 

  26. Kwiatkowska K, Milczarek O, Dębicka M, Baliga Z, Maryniak A, Kwiatkowski S. Epilepsy and cognitive deterioration as postoperative complications of the arachnoid cyst fenestration. Clin Neuropsychol. 2020;26:1–11. https://doi.org/10.1080/13854046.2020.1837959.

    Article  Google Scholar 

  27. Landgrave-Gómez J, Mercado-Gómez OF, Vázquez-García M, Rodríguez-Molina V, Córdova-Dávalos L, et al. Anticonvulsant effect of time-restricted feeding in a pilocarpine-induced seizure model: metabolic and epigenetic implications. Front Cell Neurosci. 2016;10:1–12. https://doi.org/10.3389/fncel.2016.00007.

    Article  CAS  Google Scholar 

  28. Leventer RJ, Jansen A, Pilz DT, Stoodley N, Marini C, et al. Clinical and imaging heterogeneity of polymicrogyria: a study of 328 patients. Brain. 2010;133(Pt 5):1415–27. https://doi.org/10.1093/brain/awq078.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Martínez-Lage JF, Poza M, Rodriguez Costa T. Bilateral temporal arachnoid cysts in neurofibromatosis. J Child Neurol. 1993;8(4):383–5. https://doi.org/10.1177/088307389300800417.

    Article  PubMed  Google Scholar 

  30. Martínez JO, Pisón JL, Simón BC, García-Iñiguez JP, Villagrasa PS, Hidalgo ML. Intracranial arachnoid cysts and epilepsy in children: should this be treated surgically? Our 29-year experience and review of the literature. Neurocirugia. 2021;16:S1130-1473(21)00033-6. https://doi.org/10.1016/j.neucir.2021.03.003.

    Article  Google Scholar 

  31. Masoudi M, Yousefi O, Azami P. Results of surgical treatment in patients with intracranial arachnoid cyst during last 5 years in a referral center in a developing country: Shiraz, Iran. World Neurosurg. 2021;150:e420–6. https://doi.org/10.1016/j.wneu.2021.03.038.

    Article  PubMed  Google Scholar 

  32. Meeren H, van Luijtelaar G, Lopes da Silva F, Coenen A. Evolving concepts on the pathophysiology of absence seizures. Arch Neurol. 2005;62(3):371. https://doi.org/10.1001/archneur.62.3.371.

    Article  PubMed  Google Scholar 

  33. Murthy JMK. Intracranial arachnoid cysts: epileptic seizures. Neurol India. 2013;61(4):343. https://doi.org/10.4103/0028-3886.117580.

    Article  CAS  PubMed  Google Scholar 

  34. Nasr MJ, Zohrevand AH, Khatir AA. Late onset epilepsia partialis continua in a middle-aged patient with huge arachnoid cyst. Casp J Intern Med. 2021;12(Suppl 2):464–6. https://doi.org/10.22088/cjim.12.0.464.

    Article  Google Scholar 

  35. Nikolić I, Ristić A, Vojvodić N, Baščarević V, Ilanković A, et al. The association of arachnoid cysts and focal epilepsy: hospital based case control study. Clin Neurol Neurosurg. 2017;159:39–41. https://doi.org/10.1016/j.clineuro.2017.05.014.

    Article  PubMed  Google Scholar 

  36. Okada Y, Hamano K, Iwasaki N, Horigome Y, Enomoto T, et al. Epilepsy accompanied by intracranial arachnoid cysts: Studies on volume and regional cerebral blood perfusion using MRI and SPECT. J Epilepsy. 1998;11(4):195–201. https://doi.org/10.1016/S0896-6974(98)00017-6.

    Article  Google Scholar 

  37. Pain M, Ghatan S. Arachnoid cysts in childhood. Neurological surgery, vol. 2. New York: Elsevier Saunders; 2017. p. 1524–30.

    Google Scholar 

  38. Pressler RM, Cilio MR, Mizrahi EM, Moshé SL, Nunes ML, et al. The ILAE classification of seizures and the epilepsies: modification for seizures in the neonate. Position paper by the ILAE Task Force on Neonatal Seizures. Epilepsia. 2021;62(3):615–28. https://doi.org/10.1111/epi.16815.

    Article  PubMed  Google Scholar 

  39. Rabiei K, Jaraj D, Marlow T, Jensen C, Skoog I, Wikkelsø C. Prevalence and symptoms of intracranial arachnoid cysts: a population-based study. J Neurol. 2016;263(4):689–94. https://doi.org/10.1007/s00415-016-8035-1.

    Article  PubMed  Google Scholar 

  40. Recio MV, Gallagher MJ, McLean MJ, Abou-Khalil B. Clinical features of epilepsy in patients with cerebellar structural abnormalities in a referral center. Epilepsy Res. 2007;76(1):1–5. https://doi.org/10.1016/j.eplepsyres.2007.05.006.

    Article  PubMed  Google Scholar 

  41. Sajko T, Hećimović H, Borić M, Sesar N, Rotim K. Complete resolution of medically refractory temporal lobe epilepsy after arachnoid cyst fenestration. Acta Clin Croat. 2011;50(4):589–93. PMID: 22649891.

    PubMed  Google Scholar 

  42. Scheffer IE, Berkovic S, Capovilla G, Connolly MB, French J, et al. Classification of the epilepsies: position paper of the Commission for Classification and Terminology. Epilepsia. 2017;58(4):512–21. https://doi.org/10.1111/epi.13670.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Sgouros S, Chamilos C. Pathophysiology of intracranial arachnoid cysts. In: Arachnoid cysts. Elsevier; 2018. p. 67–74. https://doi.org/10.1016/B978-0-12-809932-2.00006-5.

  44. Spacca B, Kandasamy J, Mallucci CL, Genitori L. Endoscopic treatment of middle fossa arachnoid cysts: a series of 40 patients treated endoscopically in two centres. Childs Nerv Syst. 2010;26(2):163–72. https://doi.org/10.1007/s00381-009-0952-1.

    Article  PubMed  Google Scholar 

  45. Tamburrini G, Del Fabbro M, Di Rocco C. Sylvian fissure arachnoid cysts: a survey on their diagnostic workout and practical management. Childs Nerv Syst. 2008;24(5):593–604. https://doi.org/10.1007/s00381-008-0585-9.

    Article  PubMed  Google Scholar 

  46. Vaquerizo-Madrid J. Sylvian arachnoid cysts, temporal lobe hypoplasia and epileptic encephalopathy. Rev Neurol. 1999;29(12):1188–9. PMID: 10652748.

    CAS  PubMed  Google Scholar 

  47. Ventura N, D’Andrea I, Cardoso MFBS, Alves-Leon SV, Gasparetto EL. Arachnoid cysts and absence epilepsy an evidence or a coincidence? Arq Neuropsiquiatr. 2011;69(2 A):262–3. https://doi.org/10.1590/S0004-282X2011000200024.

    Article  PubMed  Google Scholar 

  48. Wang C, Liu C, Xiong Y, Han G, Yang H, et al. Surgical treatment of intracranial arachnoid cyst in adult patients. Neurol India. 2013;61(1):60. https://doi.org/10.4103/0028-3886.108013.

    Article  PubMed  Google Scholar 

  49. Wang P-J, Lin H-C, Liu H-M, Tseng C-L, Shen Y-Z. Intracranial arachnoid cysts in children: related signs and associated anomalies. Pediatr Neurol. 1998;19(2):100–4. https://doi.org/10.1016/S0887-8994(98)00020-4.

    Article  CAS  PubMed  Google Scholar 

  50. Wester K. Intracranial arachnoid cysts and epilepsy. Elsevier Inc.; 2017. p. 23–8. https://doi.org/10.1016/B978-0-12-814378-0.00003-0.

    Book  Google Scholar 

  51. Wieser H-G, Rudolph U, Blau N, Boison D, Imhof H-G, et al. Amino acid composition of brain cysts: levels of excitatory amino acids in cyst fluid fail to predict seizures. Epilepsy Res. 2013;55(3):191–9. https://doi.org/10.1016/S0920-1211(03)00106-2.

    Article  CAS  Google Scholar 

  52. Yalçın AD, Öncel Ç, Kaymaz A, Kuloğlu N, Forta H. Evidence against association between arachnoid cysts and epilepsy. Epilepsy Res. 2002;49(3):255–60. https://doi.org/10.1016/S0920-1211(02)00050-5.

    Article  PubMed  Google Scholar 

  53. Yalçın AD, Toydemir HE, Çelebi LG, Forta H. Panayiotopoulos syndrome with coincidental brain lesions. Epileptic Disord. 2009;11(3):270–6. https://doi.org/10.1684/epd.2009.0267.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurophysiology, Mohamed V Teaching Military Hospital, Mohamed V University in Rabat, Rabat, Morocco

    Amal Satte

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Editors and Affiliations

  1. Department of Neurosurgery, Aydın Adnan Menderes University, Aydın, Türkiye

    Mehmet Turgut

  2. Department of Neurosurgery, Mohammed V University in Rabat, Rabat, Morocco

    Ali Akhaddar

  3. Department of Radiology, Ankara Medipol University, Ankara, TĂĽrkiye

    Ahmet T. Turgut

  4. Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, NY, USA

    Walter A. Hall

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Satte, A. (2023). Epilepsy and Arachnoid Cysts. In: Turgut, M., Akhaddar, A., Turgut, A.T., Hall, W.A. (eds) Arachnoid Cysts. Springer, Cham. https://doi.org/10.1007/978-3-031-22701-1_20

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