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Pediatric stroke presenting as a seizure

Katie L Ahmadzadeh1, Vartika Bhardwaj1, Steven A Johnson1

  • 1Department of Emergency Medicine, Lehigh Valley Hospital, USF Morsani COM, CC & I-78, Allentown, PA 18103, USA.

Case Reports in Emergency Medicine
|January 15, 2015
PubMed

Insights

Pediatric arterial ischemic stroke (AIS) can present as a seizure, even in children with a history of seizures. Emergency physicians must consider stroke in pediatric seizure cases to ensure timely diagnosis and treatment.

Area of Science:

  • Neurology
  • Pediatrics
  • Emergency Medicine

Background:

  • Childhood arterial ischemic stroke (AIS) is a rare but serious condition.
  • Prompt diagnosis and management of pediatric AIS are critical.
  • Seizures can be an initial presenting symptom of AIS in children.

Purpose of the Study:

  • To highlight the importance of recognizing seizures as a potential symptom of pediatric AIS.
  • To emphasize the need for prompt diagnostic evaluation in children presenting with new-onset or altered seizure activity.

Main Methods:

  • Case report of a five-year-old female presenting with seizures.
  • Diagnostic workup included computed tomography (CT) and magnetic resonance imaging (MRI) of the head.

Main Results:

  • CT scan showed loss of grey-white matter differentiation, prompting MRI.
  • MRI confirmed a right-sided stroke.
  • The patient experienced a complicated hospital course and was discharged to rehabilitation.

Conclusions:

  • Emergency physicians should consider stroke in the differential diagnosis of pediatric seizures, irrespective of prior seizure history.
  • Early recognition of AIS presenting as seizures can prevent treatment delays and improve outcomes.

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