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Clinical and radiological risk factors for poststroke epilepsy in childhood

Mauricio López-Espejo1, Marta Hernández-Chávez1, Isidro Huete2

  • 1Unit of Neurology, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.

Epilepsy & Behavior : E&B
|September 26, 2018
PubMed

Insights

Young age, acute seizures, cortical infarction, and multifocal infarction are key predictors of poststroke epilepsy in children after arterial ischemic stroke. These findings aid in identifying children at higher risk for developing epilepsy following stroke.

Area of Science:

  • Neurology
  • Pediatric Neurology
  • Epileptology

Background:

  • Limited research exists on risk factors for poststroke epilepsy (PSE) in children following arterial ischemic stroke (AIS).
  • This study addresses the need to identify predictors of PSE in pediatric AIS cases.

Purpose of the Study:

  • To evaluate clinical and radiological predictors of poststroke epilepsy (PSE) in a cohort of children experiencing their first arterial ischemic stroke (AIS).

Main Methods:

  • Retrospective analysis of a single-center prospective cohort of children (excluding neonates) with a first-ever AIS.
  • Brain MRI, annual clinical evaluations for at least three years, and Cox proportional hazards regression analysis were utilized.
  • Variables included demographics, clinical presentation, stroke risk factors, and radiological characteristics.

Main Results:

  • Out of 98 children, 41 (41.8%) developed PSE.
  • Multivariate analysis identified young age at AIS, acute symptomatic seizures, cortical infarction, and multifocal infarction as significant predictors.
  • Hazard ratios indicated increased risk associated with acute seizures (HR=3.29), cortical infarction (HR=5.01), and multifocal infarction (HR=3.27).

Conclusions:

  • Young age at stroke onset, acute symptomatic seizures, cortical lesions, and multiple infarctions are independent risk factors for developing PSE in children after their first AIS.
  • These identified factors can help in risk stratification and management of pediatric AIS patients.
Abstract

Keywords:
Brain infarctionCerebrovascular diseaseChildhood arterial ischemic strokeEpilepsyPediatric strokeStroke outcome

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