Seizures and Outcome One Year After Neonatal and Childhood Cerebral Sinovenous Thrombosis.
Cerebral sinovenous thrombosis
Outcomes
Pediatric stroke
Seizures
Journal
Pediatric neurology
ISSN: 1873-5150
Titre abrégé: Pediatr Neurol
Pays: United States
ID NLM: 8508183
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
received:
05
07
2019
revised:
16
08
2019
accepted:
20
08
2019
pubmed:
29
12
2019
medline:
26
3
2021
entrez:
29
12
2019
Statut:
ppublish
Résumé
Pediatric cerebral sinovenous thrombosis is a treatable cause of brain injury, acute symptomatic seizures, and remote epilepsy. Our objective was to prospectively study epilepsy and outcomes in neonates and children one year after cerebral sinovenous thrombosis diagnosis. Patients with cerebral sinovenous thrombosis were enrolled prospectively from 21 international sites through the Seizures in Pediatric Stroke Study. Clinical data, including acute symptomatic seizures and cerebral sinovenous thrombosis risk factors, were collected at diagnosis. A neuroradiologist who was unaware of the diagnosis reviewed acute imaging. At one year, outcomes including seizure recurrence, epilepsy diagnosis, antiepileptic drug use, and modified Engel score were collected. Outcomes were assessed using the modified Rankin score and the King's Outcome Scale for Childhood Head Injury. Twenty-four participants with cerebral sinovenous thrombosis were enrolled (67% male, 21% neonates). Headache was the most common presenting symptom in non-neonates (47%, nine of 19). Nine (37.5%) presented with acute symptomatic seizures. Six (25%; 95% confidence interval, 10% to 47%) developed epilepsy by one-year follow-up. No clinical predictors associated with epilepsy were identified. King's Outcome Scale for Childhood Head Injury and modified Rankin scores at one year were favorable in 71%. Half of the patients who developed epilepsy (three of six) did not have infarcts, hemorrhage, or seizures identified during the acute hospitalization. Our study provides a prospective estimate that epilepsy occurs in approximately one-quarter of patients by one year after diagnosis of cerebral sinovenous thrombosis. Later epilepsy can develop in the absence of acute seizures or parenchymal injury associated with the acute presentation.
Sections du résumé
BACKGROUND
Pediatric cerebral sinovenous thrombosis is a treatable cause of brain injury, acute symptomatic seizures, and remote epilepsy. Our objective was to prospectively study epilepsy and outcomes in neonates and children one year after cerebral sinovenous thrombosis diagnosis.
METHODS
Patients with cerebral sinovenous thrombosis were enrolled prospectively from 21 international sites through the Seizures in Pediatric Stroke Study. Clinical data, including acute symptomatic seizures and cerebral sinovenous thrombosis risk factors, were collected at diagnosis. A neuroradiologist who was unaware of the diagnosis reviewed acute imaging. At one year, outcomes including seizure recurrence, epilepsy diagnosis, antiepileptic drug use, and modified Engel score were collected. Outcomes were assessed using the modified Rankin score and the King's Outcome Scale for Childhood Head Injury.
RESULTS
Twenty-four participants with cerebral sinovenous thrombosis were enrolled (67% male, 21% neonates). Headache was the most common presenting symptom in non-neonates (47%, nine of 19). Nine (37.5%) presented with acute symptomatic seizures. Six (25%; 95% confidence interval, 10% to 47%) developed epilepsy by one-year follow-up. No clinical predictors associated with epilepsy were identified. King's Outcome Scale for Childhood Head Injury and modified Rankin scores at one year were favorable in 71%. Half of the patients who developed epilepsy (three of six) did not have infarcts, hemorrhage, or seizures identified during the acute hospitalization.
CONCLUSION
Our study provides a prospective estimate that epilepsy occurs in approximately one-quarter of patients by one year after diagnosis of cerebral sinovenous thrombosis. Later epilepsy can develop in the absence of acute seizures or parenchymal injury associated with the acute presentation.
Identifiants
pubmed: 31882182
pii: S0887-8994(19)30816-1
doi: 10.1016/j.pediatrneurol.2019.08.012
pmc: PMC7071986
mid: NIHMS1544424
pii:
doi:
Substances chimiques
Anticonvulsants
0
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
21-26Subventions
Organisme : NINDS NIH HHS
ID : K12 NS001692
Pays : United States
Organisme : NCATS NIH HHS
ID : KL2 TR000143
Pays : United States
Investigateurs
Adam Kirton
(A)
Abdalla Abdalla
(A)
Dimitrios Zafeiriou
(D)
Neil Friedman
(N)
Tatia Aprasidze
(T)
Anneli Kolk
(A)
Jennifer Armstrong
(J)
Rebecca Ichord
(R)
None Amlie-Lefond
Gabrielle deVeber
(G)
Gordana Kovacevic
(G)
Marta Hernandez Chavez
(M)
Mark Mackay
(M)
Luigi Titomanlio
(L)
Kristin Guilliams
(K)
Jorina Elbers
(J)
Heather Fullerton
(H)
Susan Benedict
(S)
Michael Dowling
(M)
Lori Jordan
(L)
Paola Pergami
(P)
Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.
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