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The factors contributing to cavernoma\u2010related epilepsy (CRE) and drug resistance remain inconclusive. The outcomes of CRE after different treatment modalities have not yet been fully addressed. This study aimed to characterize the clinical features of patients with CRE and the long\u2010term seizure outcomes of medical and surgical treatment strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort of 135 patients with CCM who were diagnosed in 2007\u20132011 and followed up for 93.6\u00a0months on average. The patients were divided into drug\u2010resistant epilepsy (DRE;<jats:italic>n<\/jats:italic>\u00a0=\u200929), non\u2010DRE (<jats:italic>n<\/jats:italic>\u00a0=\u200945), and no epilepsy (NE;<jats:italic>n<\/jats:italic>\u00a0=\u200961).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Temporal CCM was the factor most strongly associated with the development of both CRE and DRE. The majority of patients with single temporal CCMs had CRE (86.8%,<jats:italic>n<\/jats:italic>\u00a0=\u200933), and 50% had DRE, whereas only 14.7% (<jats:italic>n<\/jats:italic>\u00a0=\u20095) with a nontemporal supratentorial CCM had DRE (<jats:italic>p<\/jats:italic>\u00a0&lt;\u2009.05). The most common lesion site in the DRE group was the mesiotemporal lobe (50%). Multiple CCMs were more frequently observed in the CRE (29.2%) than the NE (11.5%) group (<jats:italic>p<\/jats:italic>\u00a0&lt;\u2009.05). In patients with CRE, multiple lesions were associated with a higher rebleeding rate (odds ratio\u00a0=\u00a011.1), particularly in those with DRE (odds ratio\u00a0=\u00a015.4). The majority of patients who underwent resective surgery for DRE (76.5%,<jats:italic>n<\/jats:italic>\u00a0=\u200913) achieved International League Against Epilepsy Class I and II seizure outcomes even after a long disease course.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Temporal CCM not only predisposes to CRE but also is a major risk factor for drug resistance. The mesiotemporal lobe is the most epileptogenic zone. Multiple CCMs are another risk factor for CRE and increase the rebleeding risk in these patients. Surgical resection could provide beneficial long\u2010term seizure outcomes in patients with DRE.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.17309","type":"journal-article","created":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T11:26:40Z","timestamp":1653046000000},"page":"2056-2067","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Clinical characteristics and long\u2010term outcome of cerebral cavernous malformations\u2010related epilepsy"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2993-2739","authenticated-orcid":false,"given":"Yen\u2010Cheng","family":"Shih","sequence":"first","affiliation":[{"name":"Department of Neurology Taipei Veterans General Hospital, Neurological Institute Taipei Taiwan"},{"name":"School of Medicine National Yang Ming Chiao Tung University College of Medicine Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4691-2913","authenticated-orcid":false,"given":"Chien\u2010Chen","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Neurology Taipei Veterans General Hospital, Neurological Institute Taipei Taiwan"},{"name":"School of Medicine National Yang Ming Chiao Tung University College of Medicine Taipei Taiwan"},{"name":"Brain Research Center National Yang Ming Chiao Tung University College of Medicine Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5002-6581","authenticated-orcid":false,"given":"Syu\u2010Jyun","family":"Peng","sequence":"additional","affiliation":[{"name":"Professional Master Program in Artificial Intelligence in Medicine, College of Medicine Taipei Medical University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8183-1863","authenticated-orcid":false,"given":"Hsiang\u2010Yu","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Neurology Taipei Veterans General Hospital, Neurological Institute Taipei Taiwan"},{"name":"School of Medicine National Yang Ming Chiao Tung University College of Medicine Taipei Taiwan"},{"name":"Brain Research Center National Yang Ming Chiao Tung University College of Medicine Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanford P. 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