Seizures in childhood ischemic stroke in Taiwan.
In this retrospective study, we collected clinical and radiographic data on children (age range, 1 month to 18 years) with symptoms and radiographic confirmation of seizure after ischemic stroke for the period of January 1996 to July 2006. Thirty-nine out of 94 children with ischemic stroke had poststroke seizures. Thirty-three out of 39 children with poststroke seizures had new onset seizures but only data of 28 were available. Infection was the most common etiology in the early poststroke seizure group (52.4%) but not in the late poststroke seizure group (0%). Infarction involving arterial ischemic stroke of anterior circulation were the most common in both the early poststroke seizure (61.9%) and the late poststroke seizure group (57.1%). Epilepsy was the most common sequelae in both the early poststroke seizure (38.1%) and late poststroke seizure group (100%). Children who had initial focal neurological sign (100% vs. 38.1%; P=0.007) or the focal cortical dysfunction on EEG (85.7% vs. 33.3%; P=0.029) were prone to develop late poststroke seizures. Late poststroke seizures had a high risk of developing poststroke epilepsy (100% vs. 38.1%; P=0.007). We conclude that seizures commonly occur in childhood ischemic stroke. Most poststroke seizures developed at an early stage. Infection was the most common etiology that caused early poststroke seizures in childhood ischemic stroke. Initial focal neurological signs and focal cortical dysfunction on EEG are risk factors for developing epilepsy. Poststroke seizures did not affect mortality, but there was a significant difference in normal outcome and epilepsy between those with or without poststroke seizures.
Lee
Jiun-Chang
JC
Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital, #5 Fu-Shin Street, Kwei-Shan, Taoyuan 333, Taiwan.
Lin
Kuang-Lin
KL
Wang
Huei-Shyong
HS
Chou
Min-Liang
ML
Hung
Po-Cheng
PC
Hsieh
Meng-Ying
MY
Lee
Ying-Ying
YY
Lin
Jainn-Jim
JJ
Wong
Alex Mun-Ching
AM
D000293:Adolescent; D001921:Brain / Q000503:physiopathology; D002545:Brain Ischemia / Q000150:complications* / Q000503:physiopathology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D012189:Retrospective Studies; D012307:Risk Factors; D012640:Seizures / Q000209:etiology* / Q000503:physiopathology*; D020521:Stroke / Q000150:complications* / Q000503:physiopathology* / Q000628:therapy; D013624:Taiwan; D016896:Treatment Outcome