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Epilepsy in children with periventricular leukomalacia

Barış Ekici1, Nur Aydınlı, Kubilay Aydın

  • 1Istanbul University, Istanbul Medical Faculty, Department of Pediatric Neurology, Istanbul, Turkey.

Clinical Neurology and Neurosurgery
|July 30, 2013
PubMed

Insights

Periventricular leukomalacia (PVL) is linked to epilepsy development in children. Neonatal seizures and severe MRI findings in PVL patients predict epilepsy, which can be difficult to treat.

Area of Science:

  • Pediatric Neurology
  • Neuroscience
  • Developmental Pediatrics

Background:

  • Periventricular leukomalacia (PVL) is a significant cause of neurological disability in premature infants.
  • Epilepsy is a common comorbidity associated with PVL, impacting neurodevelopmental outcomes.
  • Understanding the risk factors for epilepsy in PVL is crucial for early intervention and management.

Purpose of the Study:

  • To investigate the incidence and risk factors for epilepsy development in children with PVL.
  • To identify clinical and neuroimaging predictors of epilepsy in this patient cohort.
  • To evaluate the characteristics and treatment response of epilepsy in children with PVL.

Main Methods:

  • Retrospective analysis of 108 children (2-8 years) with radiologically confirmed PVL.
  • Inclusion criteria: regular follow-up at a tertiary pediatric neurology center.
  • Data collection included neonatal seizure history, MRI findings, EEG, neurodevelopmental assessments, and epilepsy outcomes.

Main Results:

  • Epilepsy developed in 32.4% of children with PVL.
  • Neonatal seizures, prematurity, newborn asphyxia, and severe white matter abnormalities on MRI were significant risk factors for epilepsy.
  • Generalized tonic-clonic and complex partial seizures were the most common types; 40% of epileptic patients had intractable seizures.
  • Focal EEG findings correlated with better neurodevelopmental and cognitive outcomes.

Conclusions:

  • Approximately one-third of children with PVL develop epilepsy, often with challenging treatment resistance.
  • Early identification of neonatal seizures and severe MRI findings are critical for predicting epilepsy risk in PVL.
  • This highlights the need for close neurological monitoring and proactive management in children with PVL to mitigate epilepsy-related morbidity.
Abstract

Keywords:
EpilepsyNeonatal seizurePeriventricular leukomalacia

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