Seizures in patients with cerebral hemiatrophy: A prognostic evaluation.
OBJECTIVE
Cerebral hemiatrophy is a common childhood disease. It clinically manifests with seizures, hemiparesis and mental retardation.


METHODS
In this prospective study, previously untreated patients with seizures and cerebral hemiatrophy were recruited. Cerebral hemiatrophy was diagnosed on the basis of hemispheric ratio. Patients with acquired hemiconvulsion, hemiplegia, and epilepsy (HHE) syndrome were included in group A. Group B included patients with congenital HHE syndrome. Patients were followed up for 6 months for seizure recurrence.


RESULTS
Out of 42 patients 26 were in group A and 16 were in group B. After 6 months, there was significant reduction in seizure frequency (P < 0.0001) in both the groups. At least 50% reduction in seizure frequency was noted in all the patients. Complete seizure freedom was observed in 15 (35.7%) patients. Seizure recurrences were significantly higher (P = 0.008) in group A. On univariate analysis, predictors of seizure recurrences were history of febrile seizures (P = 0.013), hippocampal sclerosis (P = 0.001), thalamic atrophy (P = 0.001), basal ganglia atrophy (P = 0.001), cerebellar atrophy (P = 0.01), ventricular dilatation (P = 0.001), epileptiform discharges at presentation (P = 0.023), complex partial seizures (P = 0.006) and status epilepticus (P = 0.02). On multivariate analysis, hemispheric ratio was the only significant factor for seizure recurrence.


CONCLUSIONS
Patients with congenital hemiatrophy had better seizure control than that in patients with HHE syndrome.
Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.
Anupam
A
Jaiswal
Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.
Ravindra Kumar
RK
Garg
Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.
Hardeep Singh
HS
Malhotra
Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.
Rajesh
R
Verma
Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.
Maneesh Kumar
MK
Singh
Cerebral hemiatrophy; childhood epilepsies; epilepsy; epilepsy syndrome; febrile seizures; hemiconvulsion; hemiplegia; seizure