[Clinical and electroencephalographic analysis of epilepsy in children with hydrocephalus]
Itsuko Nishiyama1, Kyong Hon Pooh, Yoshinobu Nakagawa
1Department of Neurological Surgery, National Kagawa Children's Hospital, Zentsuuji.
Insights
Epilepsy is common in children with hydrocephalus, particularly with certain causes. Epilepsy significantly impacts intelligence prognosis in these children, highlighting its importance as a prognostic factor.
Area of Science:
- Neurology
- Pediatrics
- Neuroscience
Context:
- Hydrocephalus affects 1 in 1000 newborns, with epilepsy being a common comorbidity.
- Understanding epilepsy's impact on cognitive development in hydrocephalus is crucial for patient management.
Purpose:
- To investigate the clinical and electroencephalographic features of epilepsy in children with hydrocephalus.
- To determine the influence of hydrocephalus etiology on epilepsy incidence and control.
- To assess the relationship between epilepsy and intelligence prognosis in this pediatric population.
Summary:
- Epilepsy was present in 34% of 156 children with hydrocephalus.
- Higher epilepsy incidence and poorer seizure control were observed in hydrocephalus secondary to intracranial infection and dysgenetic hydrocephalus without dysraphism.
- Localization-related epilepsy, complex partial, and focal motor seizures were most common, with focal spikes on EEG.
- Children with epilepsy had significantly lower intelligence quotients compared to those without epilepsy.
Impact:
- Epilepsy incidence is a critical prognostic factor for intelligence in children with hydrocephalus.
- Findings guide personalized treatment strategies and prognosis prediction for pediatric hydrocephalus patients.
- Highlights the need for early epilepsy detection and management in hydrocephalic children to improve cognitive outcomes.
Abstract:
Clinical and electroencephalographic features of epilepsy and the prognosis of intelligence were investigated in 156 children with hydrocephalus. Of these 53 (34.0%) had epilepsy. The incidence and outcome of epilepsy were determined by the etiology of hydrocephalus. The incidence was high in children with hydrocephalus caused by intra-cranial infection and dysgenetic hydrocephalus without dysraphism. Furthermore, it was difficult to control the epileptic seizures in these patients. In contrast, children with dysgenetic hydrocephalus caused by dysraphism and simple hydrocephalus had lower incidence of epilepsy and epileptic seizures had been well controlled in these cases. In hydrocephalic children, localization-related epilepsy was the most common. Complex partial seizures and focal motor seizures were frequently observed. Common electroencephalographic findings were focal spikes or multi-focal spikes. The intelligence quotient was significantly lower in children with epilepsy than in those without epilepsy. All these findings suggest that the incidence of epilepsy may be a crucial prognostic factor in children with hydrocephalus.
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