Perinatal Stroke and the Risk of Developing Childhood Epilepsy

Golomb, Meredith R.; Garg, Bhuwan P.; Carvalho, Karen S.; Johnson, Cynthia S.; Williams, Linda S.

doi:10.1016/j.jpeds.2007.03.058

Cited by 85 publications

(63 citation statements)

References 20 publications

(3 reference statements)

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“…Although ultrasonography with Doppler imaging of cerebral blood flow is useful in the neonate who is too ill to transport [4,9]. Our neonate transfontanell US was normal, consistent with previous reported low sensitivity of US in PAIS especially in small, and deep seated infarction [10]. MRI showed left basal ganglia and corona radiata subacute infarction observed in the distribution of the middle cerebral artery consistent with …”

Section: Discussionsupporting

confidence: 89%

Unilateral Basal Ganglia Infarctions in a Neonate Born to a Mother with Gestational Diabetes: Case Report

Kentab¹

2016

JNSK

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Cerebral infarcts are an important cause of neonatal convulsions. Perinatal arterial ischemic stroke (PAIS) is a cerebrovascular event occurring during fetal or neonatal life, before 28 days after birth. It has an estimated incidence of one in 2300 to 5000 live births based on the consensus of the National Institute of Neurological Disorders and Stroke [1]. Over 80% of cases involve the middle cerebral artery or its branches [2]. It is an under-recognized cause of significant long -term disabilities, including hemiplegic cerebral palsy, epilepsy, cognitive delays and behavioral impairments [3]. Perinatal BG stroke is uncommon, but the true incidence is unknown. The author report the etiologic factors, clinical and neuroradiologic findings of full term neonate born to a mother with gestational diabetes who presented with right -sided clonicneonatal convulsions and had an isolated unilateral basal ganglia (BG) stroke.

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Section: Discussionsupporting

confidence: 89%

Unilateral Basal Ganglia Infarctions in a Neonate Born to a Mother with Gestational Diabetes: Case Report

Kentab¹

2016

JNSK

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“…36,37 Treatment strategies for seizures after NAIS may differ between centers. As previously reported, 5,33 poor motor outcomes were more common in patients with bilateral stroke, as was treatment with antiepileptic drugs.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Outcomes of Symptomatic Neonatal Arterial Ischemic Stroke

et al. 2015

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BACKGROUND AND OBJECTIVES: Neonatal arterial ischemic stroke (NAIS) is associated with considerable lifetime burdens such as cerebral palsy, epilepsy, and cognitive impairment. Prospective epidemiologic studies that include outcome assessments are scarce. This study aimed to provide information on the epidemiology, clinical manifestations, infarct characteristics, associated clinical variables, treatment strategies, and outcomes of NAIS in a prospective, population-based cohort of Swiss children. RESULTS: One hundred neonates (67 boys) had a diagnosis of NAIS. The NAIS incidence in Switzerland during this time was 13 (95% confidence interval [CI], 11-17) per 100 000 live births. Seizures were the most common symptom (95%). Eighty-one percent had unilateral (80% left-sided) and 19% had bilateral lesions. Risk factors included maternal risk conditions (32%), birth complications (68%), and neonatal comorbidities (54%). Antithrombotic and antiplatelet therapy use was low (17%). No serious side effects were reported. Two years after birth, 39% were diagnosed with cerebral palsy and 31% had delayed mental performance.CONCLUSIONS: NAIS in Switzerland shows a similar incidence as other population-based studies. About one-third of patients developed cerebral palsy or showed delayed mental performance 2 years after birth, and children with normal mental performance may still develop deficits later in life. WHAT'S KNOWN ON THIS SUBJECT:Neonatal arterial ischemic stroke is associated with later cerebral palsy and cognitive impairment. Many studies on neonatal ischemic stroke are limited by modest sample sizes, and prospective studies that include outcomes assessments are scarce. WHAT THIS STUDY ADDS:Results from this prospective, nationwide, population-based study provide information on the epidemiology, associated clinical variables, clinical manifestation, vascular distribution, and treatment of neonatal arterial ischemic stroke. The study also provides outcomes regarding motor function and cognition.

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“…The types of seizures and epileptic syndromes were determined based on the proposed classification by the International League Against Epilepsy (39). Epilepsy was graded according to a modified Engel classification (40). All the measured clinical variables were investigated in relation to the development of postneonatal epilepsy.…”

Section: Outcome Measuresmentioning

confidence: 99%

Neonatal seizures and postneonatal epilepsy: a 7-y follow-up study

et al. 2012

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Background: seizures are one of the most common symptoms of acute neurological disorders in newborns. This study aimed at evaluating predictors of epilepsy in newborns with neonatal seizures. Methods: We recruited consecutively 85 neonates with repeated neonatal video-electroencephalogram (eeG)-confirmed seizures between January 1999 and December 2004. The relationship between clinical, eeG, and ultrasound (Us) data in the neonatal period and the development of postneonatal epilepsy was investigated at 7 y of age. results: Fifteen patients (17.6%) developed postneonatal epilepsy. Partial or no response to anticonvulsant therapy (odds ratio (OR) 16.7, 95% confidence interval (cI): 1.8-155.8, P = 0.01; OR 47, 95% cI: 5.2-418.1, P < 0.01, respectively), severely abnormal cerebral Us scan findings (OR: 5.4; 95% cI: 1.1-27.4; P < 0.04), severely abnormal eeG background activity (OR: 9.5; 95% cI: 1.6-54.2; P = 0.01), and the presence of status epilepticus (OR: 6.1; 95% cI: 1.8-20.3; P < 0.01) were found to be predictors of epilepsy. however, only the response to therapy seemed to be an independent predictor of postneonatal epilepsy. conclusion: Neonatal seizures seem to be related to postneonatal epilepsy. Recurrent and prolonged neonatal seizures may act on an epileptogenic substrate, causing further damage, which is responsible for the subsequent clinical expression of epilepsy.

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Perinatal Stroke and the Risk of Developing Childhood Epilepsy

Abstract: Childhood epilepsy is frequent after perinatal stroke. Evidence of infarction on prenatal ultrasonography and a family history of epilepsy predict earlier onset of active seizures.

Cited by 85 publications

References 20 publications

Unilateral Basal Ganglia Infarctions in a Neonate Born to a Mother with Gestational Diabetes: Case Report

Unilateral Basal Ganglia Infarctions in a Neonate Born to a Mother with Gestational Diabetes: Case Report

Incidence and Outcomes of Symptomatic Neonatal Arterial Ischemic Stroke

Neonatal seizures and postneonatal epilepsy: a 7-y follow-up study

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