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Epilepsy in paediatric patients with schizencephaly
Ilona Kopyta1, Michał Skrzypek2, Dorota Raczkiewicz3
1Department of Paediatric Neurology, School of Medicine, Medical University of Silesia, Katowice, Poland.
Insights
Bilateral schizencephaly significantly increases the risk of seizures in children. This type of central nervous system disorder is a key factor in developing epilepsy, even drug-resistant forms.
Area of Science:
- Neurology
- Developmental Neuroscience
- Pediatric Neurology
Background:
- Schizencephaly is a rare congenital central nervous system (CNS) disorder.
- Known causes include prenatal infections, toxic exposures, and certain medications.
- It is classified as a neuronal migration disorder.
Purpose of the Study:
- To investigate the clinical presentation of schizencephaly.
- To specifically analyze the epilepsy course in pediatric patients with schizencephaly.
Main Methods:
- Retrospective analysis of 38 children diagnosed with schizencephaly.
- Statistical analysis using SAS 9.4, including U Mann-Whitney, chi-squared tests, and logistic regression.
- Assessment of epilepsy prevalence and characteristics.
Main Results:
- Epilepsy was most common in bilateral type II schizencephaly.
- Bilateral open schizencephaly was a significant risk factor for seizures (OR=11.67).
- Drug-resistant epilepsy occurred in 45% of affected children; prevalence was not linked to gender, development, or other CNS defects.
Conclusions:
- Bilateral schizencephaly is an independent risk factor for epilepsy in children.
- Understanding these risk factors is crucial for managing pediatric neurological conditions.
Introduction:
Schizencephaly is one of the rare congenital defects of the central nervous system (CNS), known as neuronal migration disorders. The etiology of schizencecephaly is unequivocal. Established etiologies include in-utero infections (cytomegalovirus and herpes simplex virus, HSV type I), toxic abuse (cocaine, alcohol), as well as drug use (warfarin).
Objectives:
he aim of the study was to analyze the clinical presentation of schizencephaly with particular consideration of the course of epilepsy in paediatric patients.
Material And Methods:
The study group consisted of 38 children with schizencephaly (20 of them had seizure) and was retrospectively assessed. Data were analyzed using SAS version 9.4. U Mann-Whitney and χ 2 tests and logistic regression analysis were used in statistical analyses.
Results:
Epilepsy was the most frequent in bilateral type II schizencephaly (p=0.033). In logistic regression analysis, the presence of bilateral open schizencephaly significantly increased the risk of seizures (OR=11.67; 95%CI 2.44-55.83; p=0.002). Drug-resistant epilepsy was observed in 9 children (45% of the children with epilepsy). Prevalence of both epilepsy and drug-resistant epilepsy in schizencephaly did not significantly depend on gender, stage of development, type or localization of schizencephaly, and other coexisting CNS defects or clinical presentation of schizencephaly at follow-up in the study group of patients.
Conclusions:
The bilateral type of schizencephaly was identified as an independent risk factor for epilepsy in the analyzed children.
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