1. Clinical and Surgical Factors Associated With Increased Epilepsy Risk in Children With Hydrocephalus.
- Author
-
Tully, Hannah M., Kukull, Walter A., and Mueller, Beth A.
- Subjects
- *
CHILDHOOD epilepsy , *HYDROCEPHALUS , *OPERATIVE surgery , *SURGICAL site infections , *COHORT analysis , *THERAPEUTICS , *DISEASE risk factors , *EPILEPSY , *LONGITUDINAL method , *RESEARCH funding , *SURGICAL complications , *RETROSPECTIVE studies , *DISEASE complications - Abstract
Background: Children with hydrocephalus are at risk for epilepsy both due to their underlying condition and as a consequence of surgical treatment; however, the relative contributions of these factors remain unknown.Objective: The authors sought to characterize epilepsy among children with infancy-onset hydrocephalus and to examine the risks of epilepsy associated with hydrocephalus subtype and with factors related to surgical treatment.Methods: We conducted a longitudinal cohort study of all children with infancy-onset hydrocephalus treated at a major regional children's hospital during 2002 to 2012, with follow-up to ascertain risk factors and epilepsy outcome through April 2015. Poisson regression was used to calculate adjusted risk ratios and 95% confidence intervals for associations.Results: Among 379 children with hydrocephalus, 86 (23%) developed epilepsy (mean onset age = 2.7 years), almost one fifth of whom had a history of infantile spasms. Relative to spina bifida-associated hydrocephalus, children with other major hydrocephalus subtypes had fourfold higher risks of developing epilepsy. Among children who underwent surgery, surgical infection doubled the risk of epilepsy (risk ratio = 2.0, 95% confidence interval = 1.4 to 3.0). Epilepsy was associated with surgical failure for intracranial reasons but not extracranial reasons (risk ratio = 1.7, 95% confidence interval = 1.1 to 2.7; risk ratio = 1.1, 95% confidence interval = 0.7 to 1.9, respectively).Conclusions: Epilepsy is common among children with hydrocephalus. Compared with children with spina bifida-associated hydrocephalus, children with other major hydrocephalus subtypes have a markedly increased risk of epilepsy. Surgical infection doubles the risk of epilepsy. [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF