Predictors of Epilepsy in Syndromic Craniosynostosis

Epilepsy is rarely observed in patients with craniofacial syndromes, with few reports in the literature devoted to identifying epilepsy predictors for this patient population. This study aims to determine potential predictors of epilepsy in syndromic craniosynostosis.

This retrospective study analyzed data from 476 patients with Apert, Crouzon, or Pfeiffer syndromes treated at 2 craniofacial centers between 2007 and 2022. Patients were divided into 2 groups: those diagnosed with epilepsy (group A) and those without (group B). Independent variables included age, number of surgeries, previous surgery performed elsewhere, neurosurgical complication during craniofacial surgery, Chiari malformation type I, meningitis, systemic complication, encephalomalacia, hydrocephalus, placement of a ventriculoperitoneal shunt, and family history of epilepsy. These variables were compared between groups. Statistical analyses were conducted using logistic regression models to identify significant epilepsy predictors.

Epilepsy was diagnosed in 24 patients, resulting in a prevalence of 5%. Significant predictors of epilepsy included previous surgeries performed elsewhere and neurosurgical complications during craniofacial surgery, with odds ratios of 853 and 902, respectively. These factors suggest that epilepsy in this population is primarily acquired rather than congenital.

The study identified a higher prevalence of epilepsy among children with syndromic craniosynostosis compared with the general population. Intracranial complications, particularly those associated with surgeries performed outside specialized centers, are key predictors of epilepsy. These findings emphasize the importance of specialized surgical care to mitigate epilepsy risk in this patient population.