İpek Polat1, Uluç Yiş2, Müge Ayanoğlu3, Derya Okur4, Pınar Edem5, Cem Paketçi6, Erhan Bayram7, Semra Hız Kurul8. 1. Department of Pediatric Neurology, Dokuz Eylul University, Faculty of Medicine, İzmir, Narlıdere, Turkey. Electronic address: ipekkalafatcilar@gmail.com. 2. Department of Pediatric Neurology, Dokuz Eylul University, Faculty of Medicine, İzmir, Narlıdere, Turkey. Electronic address: ulyis@yahoo.com. 3. Department of Pediatric Neurology, Dokuz Eylul University, Faculty of Medicine, İzmir, Narlıdere, Turkey. Electronic address: mugeayanoglu_05@hotmail.com. 4. Department of Pediatric Neurology, Dokuz Eylul University, Faculty of Medicine, İzmir, Narlıdere, Turkey. Electronic address: deryaokuraltinyaprak@gmail.com. 5. Department of Pediatric Neurology, Dokuz Eylul University, Faculty of Medicine, İzmir, Narlıdere, Turkey. Electronic address: pinaredem@gmail.com. 6. Department of Pediatric Neurology, Dokuz Eylul University, Faculty of Medicine, İzmir, Narlıdere, Turkey. Electronic address: paketci@hotmail.com. 7. Department of Pediatric Neurology, Dokuz Eylul University, Faculty of Medicine, İzmir, Narlıdere, Turkey. Electronic address: dr.erhanbayram@yahoo.com. 8. Department of Pediatric Neurology, Dokuz Eylul University, Faculty of Medicine, İzmir, Narlıdere, Turkey. Electronic address: semrahiz@hotmail.com.
Abstract
OBJECTIVES: Acute seizures and post-stroke epilepsy have been reported more frequently in patients with pediatric stroke than adults. Acute seizures in the first days of a stroke may deteriorate stroke and ischemia-related neurodegeneration and contribute to the development of post-stroke epilepsy. In this study, we aimed to investigate risk factors for the development of post-stroke epilepsy in children with arterial ischemic stroke. MATERIALS AND METHODS: We recruited 86 children with arterial ischemic stroke. We analyzed variables, including age at admission, gender, complaints at presentation, focal or diffuse neurologic signs, neurologic examination findings, laboratory investigations that were conducted at admission with stroke (complete blood cell count, biochemical-infectious-metabolic-immunological investigations, vitamin B12 levels, vitamin D levels), neuroimaging results, etiologies, time of the first seizure, time of remote seizures, and development of neurologic deficit retrospectively. Seizures during the first six hours after stroke onset were defined as 'very early seizures'. 'Early seizures' were referred to seizures during the first 48 h. Patients who experienced two or more seizures that occurred after the acute phase of seizures were classified as 'epileptic.' A binary logistic regression analysis was used to estimate risk factors. RESULTS: An acute seizure was detected in 59% and post-stroke epilepsy developed in 41% of our cohort. Binary logistic regression analysis demonstrated that 'very early seizures' increased epilepsy risk six-fold. Epilepsy was 16 times higher in patients with 'early seizures'. Low vitamin D levels were defined as a risk factor for post-stroke epilepsy. CONCLUSION: Seizures in the very early period (within the first six hours) are the most significant risk factors for the development of post-stroke epilepsy Further studies regarding seizure prevention and neuroprotective therapies are needed because post-stroke epilepsy will affect long term prognosis in patients with pediatric stroke.
OBJECTIVES: Acute seizures and post-stroke epilepsy have been reported more frequently in patients with pediatric stroke than adults. Acute seizures in the first days of a stroke may deteriorate stroke and ischemia-related neurodegeneration and contribute to the development of post-stroke epilepsy. In this study, we aimed to investigate risk factors for the development of post-stroke epilepsy in children with arterial ischemic stroke. MATERIALS AND METHODS: We recruited 86 children with arterial ischemic stroke. We analyzed variables, including age at admission, gender, complaints at presentation, focal or diffuse neurologic signs, neurologic examination findings, laboratory investigations that were conducted at admission with stroke (complete blood cell count, biochemical-infectious-metabolic-immunological investigations, vitamin B12 levels, vitamin D levels), neuroimaging results, etiologies, time of the first seizure, time of remote seizures, and development of neurologic deficit retrospectively. Seizures during the first six hours after stroke onset were defined as 'very early seizures'. 'Early seizures' were referred to seizures during the first 48 h. Patients who experienced two or more seizures that occurred after the acute phase of seizures were classified as 'epileptic.' A binary logistic regression analysis was used to estimate risk factors. RESULTS: An acute seizure was detected in 59% and post-stroke epilepsy developed in 41% of our cohort. Binary logistic regression analysis demonstrated that 'very early seizures' increased epilepsy risk six-fold. Epilepsy was 16 times higher in patients with 'early seizures'. Low vitamin D levels were defined as a risk factor for post-stroke epilepsy. CONCLUSION:Seizures in the very early period (within the first six hours) are the most significant risk factors for the development of post-stroke epilepsy Further studies regarding seizure prevention and neuroprotective therapies are needed because post-stroke epilepsy will affect long term prognosis in patients with pediatric stroke.
Authors: Seth J Deskins; Matthew Mamone; Samuel Luketich; Arin Jennings; Sydney Downey; Jacob Gelman; Richard Brant; Collin John Journal: Cureus Date: 2022-05-13