Epilepsy in patients with spina bifida in the lumbosacral region.
This study aimed to assess the relevance of epilepsy and spina bifida in the lumbosacral region. We evaluated 75 patients with spina bifida admitted to the Kyushu University Hospital from 1980 to 2004. Patients were classified as having meningocele (MC, 4 cases), myelomeningocele (MMC, 6), myeloschisis (MS, 45), and lumbosacral lipoma (LL, 20). Nine cases had epileptic disorders, and all showed MS. Meticulous neuroradiological investigations revealed cerebral abnormalities such as polymicrogyria or hypogenesis of the corpus callosum in all epileptic cases. Locations of cerebral abnormalities topographically correlated with areas of interictal EEG abnormalities. Although all epileptic cases had ventriculoperitoneal (VP) shunt for hydrocephalus before the onset of epilepsy, interictal EEG abnormalities could not be explained by location of the VP shunt. In all LL patients, neither history of epilepsy nor cerebral abnormalities were noted on magnetic resonance imaging (MRI). Epileptogenesis in spina bifida patients seemed to correlate with coexisting cerebral abnormalities in MS patients rather than with the VP shunt. However, not all spina bifida patients associated with cerebral abnormalities had epilepsy, and not all cerebral abnormalities were epileptogenic, suggesting that epilepsy in spina bifida patients was multifactorial.
Yoshida
Fumiaki
F
Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Morioka
Takato
T
Hashiguchi
Kimiaki
K
Kawamura
Tadao
T
Miyagi
Yasushi
Y
Nagata
Shinji
S
Mihara
Futoshi
F
Ohshio
Mayu
M
Sasaki
Tomio
T
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004827:Epilepsy / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007223:Infant; D008067:Lipoma / Q000145:classification / Q000473:pathology; D008161:Lumbosacral Region / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000145:classification / Q000473:pathology; D008588:Meningocele / Q000145:classification / Q000473:pathology; D016135:Spinal Dysraphism / Q000145:classification / Q000150:complications* / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000927:Anticonvulsants