Incidence of seizures in patients with myelomeningocele: a multifactorial analysis.
To determine the role of ventricular shunts as a cause of seizures in children with hydrocephalus, 190 patients with myelomeningoceles were studied. There was a low incidence of seizures (2%) in the nonshunted patients in spite of a high incidence of ventriculomegaly, whereas the overall frequency of seizures in shunted patients was 22%. Further analysis indicated factors accountable for the increase. Only 9% of patients with shunts that had never required subsequent modification had seizures; however, 22% of the patients had seizures if they had required at least one modification for malfunction alone. Patients with a history of a shunt infection had a further increase in their likelihood of developing seizures to 47%. Information concerning the incidence of seizures by location of the shunt indicated no statistical difference between frontal and parietal entry points, with a frequency of 20% and 26%, respectively; however, there was a higher incidence of seizures in a small group of patients with shunts aberrantly placed in the posterior frontal lobe.
Chadduck
W
W
Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock 72205.
Adametz
J
J
D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D002648:Child; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000601:surgery; D008591:Meningomyelocele / Q000150:complications*; D012640:Seizures / Q000209:etiology*