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Published on: September 20, 2024
Epilepsy associated with shaken baby syndrome
Marie Bourgeois1, Federico Di Rocco, Matthew Garnett
1Department of Pediatric Neurosurgery, Hôpital Necker Enfants Malades, 149 rue de Sèvres, 75015, Paris, France. marie.bourgeois@nck.aphp.fr
Insights
Shaken baby syndrome (SBS) seizures significantly impact infant development. Early recognition and management of seizures are vital for preventing neurological injury and improving outcomes in affected infants.
Area of Science:
- Pediatric neurology
- Neurodevelopmental disorders
- Child abuse and neglect
Background:
- Shaken baby syndrome (SBS) is a leading cause of infant developmental delay.
- Epileptic seizures are a frequent manifestation of SBS.
- Understanding seizure patterns is crucial for prognosis.
Purpose of the Study:
- To analyze the impact of early and late-onset seizures in infants with SBS.
- To correlate seizure characteristics with neurological outcomes.
- To evaluate the effectiveness of current management strategies.
Main Methods:
- Retrospective review of clinical and electrophysiological data.
- Inclusion of 404 hospitalized infants diagnosed with SBS.
- Analysis of seizure semiology, EEG findings, and treatment responses.
Main Results:
- 73% of infants experienced clinical epileptic seizures in the acute phase.
- Only 11% had a normal EEG upon admission.
- Persistent EEG abnormalities correlated with poor outcomes (88%) and high mortality (48%).
- Refractory epilepsy and seizure recurrence were linked to behavioral problems (96%).
Conclusions:
- Early identification and management of seizures in SBS are critical to prevent further neurological damage.
- Delayed or recurrent seizures, potentially with altered semiology, indicate a poor prognosis.
- Prompt intervention is essential for improving long-term outcomes in SBS patients.
Object:
The shaken baby syndrome (SBS) is an important cause of developmental delay in infants. Epileptic seizures are a common feature of this syndrome. The aim if this study is to analyse the impact of the early and late seizures disorder.
Materials And Methods:
We have retrospectively reviewed the clinical and electrophysiological findings in a series of 404 children hospitalised with SBS.
Results:
In the acute phase, clinical epileptic seizures of various semiologies were found in 73% of the infants. Only 11% of the children had a normal EEG on admission. A poor outcome was found in 88% of the children in case of persisting EEG anomalies despite anti-epileptic treatment with 48% mortality in these patients. The development of refractory epilepsy was also associated with a poor outcome in this series. In fact 96% of the children with seizure recurrence had behavioural problems.
Conclusions:
The early recognition and subsequent management of these seizures is vital to prevent further neurological injury. Delayed or recurrent epileptic seizures may occur with a different semiology to the seizures in the acute phase and are also associated with a poor prognosis.
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