Epilepsy After Perinatal Stroke with Different Vascular Subtypes

Overview

Journal Epilepsia Open

Date 2018 Jun 9

PMID 29881798

Citations 11

Authors

Rael Laugesaar

Ulvi Vaher

Silva Loo

Anneli Kolk

Mairi Mannamaa

Inga Talvik

Eve Oiglane-Shlik

Dagmar Loorits

Tiina Talvik

Pilvi Ilves

Affiliations

Soon will be listed here.

Abstract

Objective: With an incidence up to 63 per 100,000 live births, perinatal stroke is an important cause of childhood epilepsy. The aim of the study was to find the prevalence of and predictive factors for epilepsy, and to describe the course of epilepsy in children with perinatal stroke with different vascular subtypes.

Methods: Patients were retrieved from the Estonian Paediatric Stroke Database with follow-up time at least 24 months. Patients were divided into 5 perinatal stroke syndromes: neonatal arterial ischemic stroke (AIS), neonatal hemorrhagic stroke, neonatal cerebral sinovenous thrombosis, presumed AIS, and presumed periventricular venous infarction.

Results: The final study group included 73 children with perinatal stroke (39 boys). With a median follow-up time of 8.6 years, epilepsy was diagnosed in 21/73 (29%) children, most of whom had AIS (17/21, 81%). The 18-year cumulative poststroke epilepsy risk according to the Kaplan-Meier estimator was 40.8% (95% confidence interval [CI] 20.7-55.9%). The median age at epilepsy diagnosis was 50 months (range 1 month to 18.4 years). Children with neonatal AIS had the highest risk of epilepsy, but children with presumed AIS more often had severe epilepsy syndromes. Cortical lesions (odds ratio [OR] 19.7, 95% CI 2.9-133), and involvement of thalamus (OR 9.8, 95% CI 1.8-53.5) and temporal lobe (OR 8.3, 95% CI 1.8-39.6) were independently associated with poststroke epilepsy.

Significance: The risk for poststroke epilepsy after perinatal stroke depends on the vascular subtype. Patients with perinatal AIS need close follow-up to detect epilepsy and start with antiepileptic treatment on time.

Citing Articles

Three-year incidence and acute setting predictors of epilepsy after neonatal and childhood arterial ischaemic stroke: a disease-based cohort study.

Lopez-Espejo M, Skorin I, Mesa T, Hernandez-Chavez M Eur J Pediatr. 2024; 183(3):1415-1423.

PMID: 38170290 DOI: 10.1007/s00431-023-05384-4.

Incidence and risk factors of post-stroke seizures and epilepsy: systematic review and meta-analysis.

Nandan A, Zhou Y, Demoe L, Waheed A, Jain P, Widjaja E J Int Med Res. 2023; 51(11):3000605231213231.

PMID: 38008901 PMC: 10683575. DOI: 10.1177/03000605231213231.

The thalamus and basal ganglia are smaller in children with epilepsy after perinatal stroke.

Vaher U, Ilves N, Ilves N, Laugesaar R, Mannamaa M, Loorits D Front Neurol. 2023; 14:1252472.

PMID: 37840930 PMC: 10568465. DOI: 10.3389/fneur.2023.1252472.

[A series of 22 cases of perinatal arterial ischaemic stroke: risk factors, clinical management and neurological sequelae].

Arias-Llorente R, Lareu-Vidal S, Gonzalez-Sanchez S, Blanco-Lago R Rev Neurol. 2023; 77(7):151-158.

PMID: 37750545 PMC: 10831710. DOI: 10.33588/rn.7707.2023158.

High Prevalence of Collagenopathies in Preterm- and Term-Born Children With Periventricular Venous Hemorrhagic Infarction.

Ilves N, Pajusalu S, Kahre T, Laugesaar R, Samarina U, Loorits D J Child Neurol. 2023; 38(6-7):373-388.

PMID: 37427422 PMC: 10467006. DOI: 10.1177/08830738231186233.

References

Low E, Mathieson S, Stevenson N, Livingstone V, Ryan C, Bogue C . Early postnatal EEG features of perinatal arterial ischaemic stroke with seizures. PLoS One. 2014; 9(7):e100973. PMC: 4106759. DOI: 10.1371/journal.pone.0100973. View

Wanigasinghe J, Reid S, MacKay M, Reddihough D, Harvey A, Freeman J . Epilepsy in hemiplegic cerebral palsy due to perinatal arterial ischaemic stroke. Dev Med Child Neurol. 2010; 52(11):1021-7. DOI: 10.1111/j.1469-8749.2010.03699.x. View

Kersbergen K, Groenendaal F, Benders M, de Vries L . Neonatal cerebral sinovenous thrombosis: neuroimaging and long-term follow-up. J Child Neurol. 2011; 26(9):1111-20. PMC: 3674555. DOI: 10.1177/0883073811408090. View

van Buuren L, van der Aa N, Dekker H, Vermeulen R, van Nieuwenhuizen O, van Schooneveld M . Cognitive outcome in childhood after unilateral perinatal brain injury. Dev Med Child Neurol. 2013; 55(10):934-40. DOI: 10.1111/dmcn.12187. View

Kersbergen K, de Vries L, Leijten F, Braun K, Nievelstein R, Groenendaal F . Neonatal thalamic hemorrhage is strongly associated with electrical status epilepticus in slow wave sleep. Epilepsia. 2013; 54(4):733-40. DOI: 10.1111/epi.12131. View

Graham N, Crichton S, Koutroumanidis M, Wolfe C, Rudd A . Incidence and associations of poststroke epilepsy: the prospective South London Stroke Register. Stroke. 2013; 44(3):605-11. DOI: 10.1161/STROKEAHA.111.000220. View

Fisher R, Acevedo C, Arzimanoglou A, Bogacz A, Cross J, Elger C . ILAE official report: a practical clinical definition of epilepsy. Epilepsia. 2014; 55(4):475-82. DOI: 10.1111/epi.12550. View

Ricci D, Mercuri E, Barnett A, Rathbone R, Cota F, Haataja L . Cognitive outcome at early school age in term-born children with perinatally acquired middle cerebral artery territory infarction. Stroke. 2007; 39(2):403-10. DOI: 10.1161/STROKEAHA.107.489831. View

Lee J, Croen L, Lindan C, Nash K, Yoshida C, Ferriero D . Predictors of outcome in perinatal arterial stroke: a population-based study. Ann Neurol. 2005; 58(2):303-8. DOI: 10.1002/ana.20557. View

10.

Kirton A, deVeber G, Pontigon A, MacGregor D, Shroff M . Presumed perinatal ischemic stroke: vascular classification predicts outcomes. Ann Neurol. 2008; 63(4):436-43. DOI: 10.1002/ana.21334. View

11.

Suppiej A, Mastrangelo M, Mastella L, Accorsi P, Grazian L, Casara G . Pediatric epilepsy following neonatal seizures symptomatic of stroke. Brain Dev. 2015; 38(1):27-31. DOI: 10.1016/j.braindev.2015.05.010. View

12.

Ilves P, Laugesaar R, Loorits D, Kolk A, Tomberg T, Loo S . Presumed Perinatal Stroke: Risk Factors, Clinical and Radiological Findings. J Child Neurol. 2015; 31(5):621-8. DOI: 10.1177/0883073815609149. View

13.

Brouwer A, Groenendaal F, Koopman C, Nievelstein R, Han S, de Vries L . Intracranial hemorrhage in full-term newborns: a hospital-based cohort study. Neuroradiology. 2010; 52(6):567-76. PMC: 2872016. DOI: 10.1007/s00234-010-0698-1. View

14.

Abend N, Wusthoff C . Neonatal seizures and status epilepticus. J Clin Neurophysiol. 2012; 29(5):441-8. PMC: 3463810. DOI: 10.1097/WNP.0b013e31826bd90d. View

15.

Raju T, Nelson K, Ferriero D, Lynch J . Ischemic perinatal stroke: summary of a workshop sponsored by the National Institute of Child Health and Human Development and the National Institute of Neurological Disorders and Stroke. Pediatrics. 2007; 120(3):609-16. DOI: 10.1542/peds.2007-0336. View

16.

Laugesaar R, Kolk A, Tomberg T, Metsvaht T, Lintrop M, Varendi H . Acutely and retrospectively diagnosed perinatal stroke: a population-based study. Stroke. 2007; 38(8):2234-40. DOI: 10.1161/STROKEAHA.107.483743. View

17.

Kitai Y, Haginoya K, Hirai S, Ohmura K, Ogura K, Inui T . Outcome of hemiplegic cerebral palsy born at term depends on its etiology. Brain Dev. 2015; 38(3):267-73. DOI: 10.1016/j.braindev.2015.09.007. View

18.

Grunt S, Mazenauer L, Buerki S, Boltshauser E, Capone Mori A, Datta A . Incidence and outcomes of symptomatic neonatal arterial ischemic stroke. Pediatrics. 2015; 135(5):e1220-8. DOI: 10.1542/peds.2014-1520. View

19.

Ferlazzo E, Gasparini S, Beghi E, Sueri C, Russo E, Leo A . Epilepsy in cerebrovascular diseases: Review of experimental and clinical data with meta-analysis of risk factors. Epilepsia. 2016; 57(8):1205-14. DOI: 10.1111/epi.13448. View

20.

Golomb M, Garg B, Carvalho K, Johnson C, Williams L . Perinatal stroke and the risk of developing childhood epilepsy. J Pediatr. 2007; 151(4):409-13, 413.e1-2. PMC: 2570344. DOI: 10.1016/j.jpeds.2007.03.058. View