Celina v. Stülpnagel, Tom Pieper, Karen Lidzba, Hans
Holthausen, Martin Staudt, Gerhard
Kluger. Early seizures predict the
development of epilepsy in children and adolescents with stroke. European Journal of Paediatric
Neurology. In press.
Highlights
•Identification of risk factors for epilepsy (E) after
post-neonatal pediatric stroke.
•Retrospective analysis of 93 children with post-neonatal
non-traumatic stroke.
•Early seizures, young age, cortical involvement on MRI more
frequently with E.
•Stepwise multiple regression analysis in 46/93 patients
with complete datasets.
•Identification of only early seizures as significant risk
factor.
Summary
Purpose
To identify risk factors for the development of epilepsy
after pediatric stroke.
Methods
Retrospective analysis of hospital charts of 93 children and
adolescents with post-neonatal non-traumatic stroke and a minimum follow-up of
two years. Seizures during the first 48 hours after onset of stroke symptoms
were defined as “early seizures”; when two or more seizures occurred after this
period, the patient was classified as “epileptic”.
Results
Early seizures, young age at stroke and MRI evidence of
cortical involvement were observed more frequently in the children who
developed epilepsy. These factors were, however, significantly interrelated; a
stepwise multiple regression analysis in 46/93 patients with complete datasets
identified only the occurrence of early seizures as a significant risk factor:
15/19 (79%) children with early seizures developed epilepsy, as opposed to only
7/53 (13%) without early seizures.
Conclusion
Children with stroke who show seizures during the first 48
hours after onset of stroke symptoms have a high risk to develop post-stroke
epilepsy, whereas in children without early seizures, post-stroke epilepsy is
rare.
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