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This chapter discusses the demographic data, pathological characteristics and pathophysiological mechanisms of epilepsy in Cavernous malformations (CMs). It presents genetic aspects, clinical features, diagnostic tools and therapeutic options for CMs. CMs are characterized by low-flow sinusoidal vessels lined by thin endothelial walls with no obvious feeding arteries or venous drainage. For an optimal therapeutic approach it is mandatory to understand the epilepsy inducing mechanisms associated with CMs. Numerous studies of magnetoencephalography (MEG) in medically intractable epilepsy have shown that MEG can detect interictal and ictal epileptiform activity. The role in diagnosis and the history of imaging techniques such as cerebral angiography, computed tomography (CT), and magnetic resonance imaging (MRI) as well as the radiological characteristics of CM have been extensively reviewed in recent literature. The optimal management of CMs presenting with epileptic seizures is still a matter of debate.
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