Electro-Clinical Follow-up of Shunted Hydrocephalic Children

Varfis, G.; Berney, J; Beaumanoir, A

doi:10.1159/000119661

Cited by 17 publications

(14 citation statements)

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“…While postshunt seizures are not related to hydrocephalus etiology, it might be possible to prevent them; preshunt seizures are related to the etiology and difficult to be prevented. Although age at shunting was not a significant factor in some studies [1,3,4,20,21,25], others, like our study, showed that shunt at a younger age is a risk factor of developing seizures in shunted patients [7,8]. …”

Section: Discussioncontrasting

confidence: 58%

“…Thus, it is important to identify the risk factors of seizure disorders in shunted hydrocephalus which helps us to prevent the seizures and associated problems. Birth injuries, etiology of hydrocephalus, age at initial shunt placement, associated shunt malfunctions and infections, high number of shunt revisions, concomitant pathology, and presence of special types of central nervous system malformations are considered to be risk factors of seizures in shunted hydrocephalus [1,2,5,8]. However, there are lots of discrepancies among different studies about the role and importance of each risk factor [2].…”

Section: Introductionmentioning

confidence: 99%

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Seizure Risk Factors in Shunted Hydrocephalic Patients

Majed¹,

Andrabi²,

Nejat³

et al. 2012

Pediatr Neurosurg

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Objective: There are controversies about seizure risk factors in shunted hydrocephalic patients which can be due to having merged two different types of seizure (preshunt and postshunt seizures) in previous studies. Also, it is not known whether a considerable change in ventricular size after shunting can be a risk factor of postshunt seizures. Methods: 150 hydrocephalic patients who underwent shunting from 2006 to 2011 in the Children's Hospital Medical Center in Tehran, Iran, were visited at least 1 year after shunting to assess risk factors of preshunt and postshunt seizures. Ventricular size was assessed by using a radiologic index of bifrontal ratio (BFR). Results: Preshunt seizures were higher in patients with postinfectious hydrocephalus and intraventricular hemorrhage. Early shunting, history of shunt complications and shunt infection, and a high number of shunt revisions were significant risk factors for developing postshunt seizures. The change in BFR after shunting was not a significant risk factor of postshunt seizures. Conclusion: The difference between risk factors of preshunt seizures and postshunt seizures shows that they are two different types of seizures with different natures. Preshunt seizures are hard to prevent as they are related to the underlying disease of the brain or the etiology of hydrocephalus. However, postshunt seizures are related to the shunt and might be decreased by preventing shunt complications.

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Section: Discussioncontrasting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Seizure Risk Factors in Shunted Hydrocephalic Patients

Majed¹,

Andrabi²,

Nejat³

et al. 2012

Pediatr Neurosurg

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“…Graebner and Celesia [9] stated that 62% of subjects in the nonshunted group and 85% in the shunted group had abnormal EEGs, and focal specific paroxysmal discharges were present in 38% in the shunted group, in contrast to only 10% in the nonshunted group. Comparing EEG recordings taken before and after shunt surgery, Varfis et al [24] supported the view that an epileptogenic focus has developed around the place of ventricular catheter of the shunt system. Among shunted hydrocephalic patients after meningitis or intraventricular hemorrhage fits other than generalized convulsions were rare, while generalized and focal fits were equally represented in the hydrocephalic patients after Chiari malformation or aqueduct stances [22].…”

Section: Discussionmentioning

confidence: 93%

“…many others [17,24,23] that there is an increased risk of seizures in patients with CNS malformations, while only Copeland et al [6] were not able to convince their readers that there was a correlation between pathologic conditions causing hydrocephalus and the incidence of seizures. Mental retardation is another factor that aggravates the risk of having or developing seizures.…”

Section: Discussionmentioning

confidence: 99%

Hydrocephalus and epilepsy

Sato¹,

Yamguchi²,

Kittaka³

et al. 2001

Child's Nervous System

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Since the introduction of ventriculo-atrial and/or ventriculo-peritoneal shunting for hydrocephalic patients, controversies have developed regarding the likelihood of epileptic seizures developing as a result of the shunting itself and/or its complications. On the other hand, hydrocephalus is not commonly recognized as a cause of seizures in general, although epilepsy is reported to be frequently associated with shunt-treated hydrocephalus, especially in children. Several authors have reported an increased risk of epileptic seizures after shunt placement, but the underlying mechanisms are still controversial. The insult to the brain at the time of ventricular catheter insertion, the presence of the shunt tube itself as a foreign body, the burr hole location, the number of shunt revisions after malfunction, associated infection, the etiology of hydrocephalus, and associated mental retardation are thought to be related to the risk of epilepsy. Age at the time of initial shunt placement also seems to be an important factor. Early shunting is a well-known determinant of risk in shunt obstruction, and children less than 2 years old are consequently at a higher risk of developing epilepsy than older ones. It is reported that antiepileptic drug treatment is not so reliable as might be expected. Conscientious and more sophisticated EEG recording in those children may be beneficial during follow-up. The incidence of seizures in shunted children is reported to be quite high, ranging from 20% to approximately 50%, so that neurosurgeons should pay more attention to the issue of epilepsy in hydrocephalic children. Although ventriculo-extracranial shunts have been the standard treatment for hydrocephalus for decades, the long-term morbidity, including postshunt epileptic seizures, has to be taken seriously. The use of neuroendoscopic techniques when indicated may ameliorate this problem a great deal in the future.

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“…[1718] Brainstem auditory evoked potentials, when serially performed, help in identifying the structural abnormalities of brainstem and can also be an earlier indicator of shunt malfunction [Tables 1 and 2]. [19–21]…”

Section: Historymentioning

confidence: 99%

Hydrocephalus Indian scenario – A review

Venkataramana

2011

J Pediatr Neurosci

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Hydrocephalus is a common clinical problem seen in pediatric neurosurgical practice. Hydrocephalus involves dilatation of the cerebral ventricular system with corresponding, compressive effects on the parenchyma. It can be communicative or obstructive types. Congenital, acquired, infective, and secondary hydrocephalus have different clinical features with different modality of treatments. Ventriculoperitoneal shunt is the gold standard of treatment. Endoscopic 3rd ventriculostomy is rapidly gaining prominence as an alternative. Various kinds of hydrocephalus, their pathophysiology, treatment and complications are reviewed.

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Electro-Clinical Follow-up of Shunted Hydrocephalic Children

Cited by 17 publications

References 0 publications

Seizure Risk Factors in Shunted Hydrocephalic Patients

Seizure Risk Factors in Shunted Hydrocephalic Patients

Hydrocephalus and epilepsy

Hydrocephalus Indian scenario – A review

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