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Risk Factors for Seizures and Epilepsy in Children With Congenital Heart Disease

Suman Ghosh1, Joseph Philip2, Nikita Patel3

  • 1Division of Pediatric Neurology, University of Florida, Gainesville, FL, USA.

Journal of Child Neurology
|February 28, 2020
PubMed

Insights

Congenital heart disease patients with stroke are at higher risk for epilepsy. Risk factors for seizures include brain injury, high-risk surgery, and low birth weight, impacting hospital stay but not always leading to epilepsy.

Area of Science:

  • Pediatric Cardiology
  • Pediatric Neurology
  • Neonatal Care

Background:

  • Congenital heart disease (CHD) affects numerous infants, often requiring surgical intervention.
  • Seizures and epilepsy are potential complications in this vulnerable population.
  • Understanding risk factors is crucial for early detection and management.

Purpose of the Study:

  • To identify risk factors for pre- and postoperative seizures and epilepsy in infants with CHD.
  • To investigate the association between early seizures and later epilepsy development.
  • To determine predictors of seizure development in neonates and infants undergoing cardiopulmonary bypass.

Main Methods:

  • Retrospective cohort study of 247 neonates and infants (<3 months) with CHD who underwent cardiopulmonary bypass.
  • Classification of seizures into early preoperative, early postoperative, and late postoperative categories.
  • Epilepsy defined as recurring seizures within 30 days post-cardiac surgery.

Main Results:

  • 5.3% of the cohort developed late postoperative epilepsy; the majority of seizures began after 1 year of age.
  • Risk factors for seizures included brain injury (P < .001), high-risk surgery (P = .024), and low birth weight (P < .04).
  • Infants diagnosed with stroke were more likely to develop epilepsy (P = .04) and seizures were associated with increased length of stay (P < .001).

Conclusions:

  • Stroke in neonates/infants with CHD is associated with epilepsy development, potentially without prior early seizures.
  • Brain injury, high-risk surgery, and lower birth weight are significant risk factors for seizures in this population.
  • While seizures correlate with longer hospital stays, they do not invariably predict subsequent epilepsy.
Abstract

Keywords:
brainepilepsyinfantneonatal seizuresneonateseizuresstrokesurgery

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