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- Title
Prolonged or recurrent acute seizures after pediatric arterial ischemic stroke are associated with increasing epilepsy risk.
- Authors
Fox, Christine K; Mackay, Mark T; Dowling, Michael M; Pergami, Paola; Titomanlio, Luigi; Deveber, Gabrielle; Kirton, Adam; Abdalla, Abdalla; Zafeiriou, Dimitrios; Friedman, Neil; Tatishvili, Nana; Kolk, Anneli; Armstrong‐Wells, Jennifer; Ichord, Rebecca; Amlie‐Lefond, Catherine; Kovacevic, Gordana; Chavez, Marta Hernandez; Stojanovski, Belinda; Guilliams, Kristin; Elbers, Jorina
- Abstract
<bold>Aim: </bold>To determine epilepsy risk factors after pediatric stroke.<bold>Method: </bold>A cohort of children with arterial ischemic stroke (birth-18y) was enrolled at 21 centers and followed for 1 year. Acute seizures (≤7d after stroke) and active epilepsy (at least one unprovoked remote seizure plus maintenance anticonvulsant at 1y) were identified. Predictors were determined using logistic regression.<bold>Results: </bold>Among 114 patients (28 neonates and 86 children) enrolled, 26 neonates (93%) and 32 children (37%) had an acute seizure. Acute seizures lasted longer than 5 minutes in 23 patients (40%) and were frequently recurrent: 33 (57%) had 2 to 10 seizures and 11 (19%) had more than 10. Among 109 patients with 1-year follow-up, 11 (10%) had active epilepsy. For each year younger, active epilepsy was 20% more likely (odds ratio [OR] 0.8, 95% confidence interval [CI] 0.6-0.99, p=0.041). Prolonged or recurrent acute seizures also increased epilepsy risk. Each additional 10 minutes of the longest acute seizure increased epilepsy risk fivefold (OR 4.7, 95% CI 1.7-13). Patients with more than 10 acute seizures had a 30-fold increased epilepsy risk (OR 30, 95% CI 2.9-305).<bold>Interpretation: </bold>Pediatric stroke survivors, especially younger children, have a high risk of epilepsy 1 year after stroke. Prolonged or recurrent acute seizures increase epilepsy risk in a dose-dependent manner.
- Subjects
STROKE; MULTI-infarct dementia; MELAS syndrome; MITOCHONDRIAL encephalomyopathies; MITOCHONDRIAL myopathy; AGE distribution; CEREBRAL ischemia; COMPARATIVE studies; EPILEPSY; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; ONLINE information services; RESEARCH; DISEASE relapse; EVALUATION research; DISEASE complications
- Publication
Developmental Medicine & Child Neurology, 2017, Vol 59, Issue 1, p38
- ISSN
0012-1622
- Publication type
journal article
- DOI
10.1111/dmcn.13198