title: Seizures as a presenting symptom of acute arterial ischemic stroke in childhood.
abstract: OBJECTIVE
  To define the incidence of seizures as a presenting symptom of acute arterial ischemic stroke (AIS) in children and to determine whether younger age, infarct location, or AIS etiology were risk factors for seizure at AIS presentation.
  
  
  METHODS
  Children aged 2 months to 18 years presenting with AIS between January 2005 and December 2008 were identified from a single center prospective pediatric stroke registry. Clinical data were abstracted, and a neuroradiologist reviewed imaging studies.
  
  
  RESULTS
  Among the 60 children who met our inclusion criteria, 13 experienced seizure at stroke presentation (22%). Median age was significantly younger in children who presented with seizures than in those who did not (1.1 years vs 10 years; P = .0009). Seizures were accompanied by hemiparesis in all patients. Three of 4 children with clinically overt seizures at presentation also had nonconvulsive seizures on continuous electroencephalography monitoring.
  
  
  CONCLUSIONS
  Twenty-two percent of children with acute AIS present with seizures. Seizures were always accompanied by focal neurologic deficits. Younger age was a risk factor for seizures at presentation. Seizure at presentation was not associated with infarct location or etiology. Nonconvulsive seizures may occur during the acute period.
authors.affiliation: Department of Neurology, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. abend@email.chop.edu
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Abend
authors.forename: Lauren A
authors.initials: LA
authors.lastname: Beslow
authors.forename: Sabrina E
authors.initials: SE
authors.lastname: Smith
authors.forename: Sudha K
authors.initials: SK
authors.lastname: Kessler
authors.forename: Arastoo
authors.initials: A
authors.lastname: Vossough
authors.forename: Stefanie
authors.initials: S
authors.lastname: Mason
authors.forename: Shannon
authors.initials: S
authors.lastname: Agner
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Licht
authors.forename: Rebecca N
authors.initials: RN
authors.lastname: Ichord
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D017677:Age Distribution; D002545:Brain Ischemia / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D010291:Paresis / Q000453:epidemiology; D012042:Registries; D012640:Seizures / Q000453:epidemiology / Q000209:etiology*; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology