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Perinatal stroke is a significant cause of childhood epilepsy. Epilepsy risk varies by stroke type, with arterial ischemic stroke (AIS) posing the highest risk, necessitating close monitoring.

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Area of Science:

  • Neurology
  • Pediatrics
  • Epidemiology

Background:

  • Perinatal stroke is a leading cause of childhood epilepsy, affecting up to 63 per 100,000 live births.
  • Understanding epilepsy prevalence and risk factors in perinatal stroke survivors is crucial for early intervention.

Purpose of the Study:

  • To determine the prevalence and predictive factors of epilepsy in children with perinatal stroke.
  • To describe the epilepsy course across different perinatal stroke vascular subtypes.

Main Methods:

  • Retrospective analysis of the Estonian Paediatric Stroke Database with a minimum 24-month follow-up.
  • Classification of perinatal stroke into five syndromes: neonatal arterial ischemic stroke (AIS), neonatal hemorrhagic stroke, neonatal cerebral sinovenous thrombosis, presumed AIS, and presumed periventricular venous infarction.

Main Results:

  • Epilepsy was diagnosed in 29% of 73 children with perinatal stroke over a median follow-up of 8.6 years.
  • The 18-year cumulative epilepsy risk was 40.8%, highest in neonatal AIS.
  • Cortical lesions, thalamus, and temporal lobe involvement were independently associated with poststroke epilepsy.

Conclusions:

  • The risk of poststroke epilepsy is significantly influenced by the vascular subtype of perinatal stroke.
  • Children with perinatal arterial ischemic stroke require vigilant follow-up for timely epilepsy detection and treatment.