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Seizures as a presenting symptom of acute arterial ischemic stroke in childhood

Nicholas S Abend1, Lauren A Beslow, Sabrina E Smith

  • 1Department of Neurology, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. abend@email.chop.edu

The Journal of Pediatrics
|March 25, 2011
PubMed

Insights

In children with acute arterial ischemic stroke (AIS), 22% presented with seizures, particularly younger children. Seizures at presentation were linked to focal neurological deficits but not stroke cause or location.

Area of Science:

  • Pediatric Neurology
  • Neuroscience
  • Stroke Research

Background:

  • Acute arterial ischemic stroke (AIS) in children is a significant cause of neurological disability.
  • Seizures are a known complication of stroke, but their incidence and associated risk factors in pediatric AIS require further definition.

Purpose of the Study:

  • To determine the incidence of seizures as a presenting symptom in pediatric AIS.
  • To identify risk factors, including age, infarct location, and etiology, associated with seizures at AIS presentation.

Main Methods:

  • A prospective pediatric stroke registry was utilized to identify children aged 2 months to 18 years with AIS.
  • Clinical data and imaging studies were reviewed to assess seizure occurrence and related factors.

Main Results:

  • Of 60 children with AIS, 13 (22%) experienced seizures at presentation.
  • Younger age was a significant risk factor for seizures (median age 1.1 years vs. 10 years).
  • All seizure patients had hemiparesis; 3 of 4 with overt seizures also had nonconvulsive seizures.

Conclusions:

  • Seizures are a common presenting symptom in pediatric AIS, occurring in 22% of cases.
  • Younger age is a key risk factor for seizures at AIS presentation.
  • Nonconvulsive seizures may be present during the acute phase of pediatric AIS.
Abstract

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