Neurovascular Lesions in Pediatric Epilepsy
J Kassiri1, T Rajapakse1, M Wheatley2
11 Division of Pediatric Neurology, University of Alberta, Edmonton, Alberta, Canada.
Journal of Child Neurology
|May 9, 2019
Summary
Pediatric neurovascular lesions often present as focal seizures. Surgery for these lesions in children with epilepsy offers limited seizure freedom, necessitating long-term antiepileptic drug treatment.
Area of Science:
- Pediatric Neurology
- Neurovascular Surgery
- Epilepsy Research
Background:
- Neurovascular lesions are uncommon and poorly understood in children.
- Initial symptoms can include seizures, focal neurological deficits, or headaches.
Purpose of the Study:
- To investigate the clinical presentation and natural history of neurovascular lesions in pediatric epilepsy patients.
- To analyze outcomes following surgical intervention for these lesions.
Main Methods:
- Retrospective review of pediatric epilepsy patients diagnosed with neurovascular lesions from 2006-2018.
- Assessment of initial clinical presentation, neuroimaging, and long-term epilepsy and postsurgical outcomes.
Main Results:
- Focal seizures with impaired awareness were the most common initial presentation (10/14 patients).
- Cavernous angiomas and arteriovenous malformations were the most frequent lesion types.
- All patients undergoing neurovascular surgery required long-term antiepileptic drug treatment.
Conclusions:
- Focal seizures are a key initial presentation for pediatric neurovascular lesions, irrespective of lesion type.
- Seizure freedom after neurovascular surgery in pediatric epilepsy patients is limited.
- Long-term antiepileptic drug management is crucial for seizure control post-surgery.
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