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Seizures and Outcome One Year After Neonatal and Childhood Cerebral Sinovenous Thrombosis.

Authors :
Mineyko, Aleksandra
Kirton, Adam
Billinghurst, Lori
Tatishvili, Nana Nino
Wintermark, Max
deVeber, Gabrielle
Fox, Christine
SIPS Investigators
Source :
Pediatric Neurology. Apr2020, Vol. 105, p21-26. 6p.
Publication Year :
2020

Abstract

<bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusion: </bold>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. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
08878994
Volume :
105
Database :
Academic Search Index
Journal :
Pediatric Neurology
Publication Type :
Academic Journal
Accession number :
142222113
Full Text :
https://doi.org/10.1016/j.pediatrneurol.2019.08.012