Golomb Meredith R, Garg Bhuwan P, Carvalho Karen S, Johnson Cynthia S, Williams Linda S
Division of Pediatric Neurology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.
J Pediatr. 2007 Oct;151(4):409-13, 413.e1-2. doi: 10.1016/j.jpeds.2007.03.058. Epub 2007 Aug 23.
To describe the prevalence of epilepsy after 6 months of age in children with perinatal stroke and examine whether perinatal data predict epilepsy onset and resolution.
A retrospective review of 64 children with perinatal stroke. In children with at least 6 months of follow-up data, Kaplan-Meier curves, univariate log-rank tests, and Cox proportional hazards models were used to examine predictors of time to development of seizures, and time to resolution of seizures in children with epilepsy. The association of risk factors with the presence of epilepsy at any time after 6 months of age was examined using Fisher's exact test.
Forty-one of the 61 children with at least 6 months of follow-up data (67%) had epilepsy between 6 months of age and last follow-up, but in 13 of 41, seizures eventually resolved and anticonvulsants were discontinued. Infarct on prenatal ultrasonography (P = .0065) and family history of epilepsy (P = .0093) were significantly associated with time to development of seizures after 6 months of age in the univariate analysis. No assessed variables were associated with time to resolution of epilepsy or with the presence of epilepsy after 6 months of age.
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.
描述围产期卒中患儿6个月龄后癫痫的患病率，并探讨围产期数据是否可预测癫痫的发作及缓解情况。
对64例围产期卒中患儿进行回顾性研究。对于有至少6个月随访数据的患儿，采用Kaplan-Meier曲线、单因素对数秩检验和Cox比例风险模型来研究癫痫发作时间及癫痫缓解时间的预测因素。使用Fisher精确检验来研究6个月龄后任何时间的危险因素与癫痫存在之间的关联。
61例有至少6个月随访数据的患儿中，41例（67%）在6个月龄至末次随访期间患有癫痫，但41例中有13例癫痫最终缓解且停用了抗惊厥药物。在单因素分析中，产前超声检查发现梗死（P = 0.0065）和癫痫家族史（P = 0.0093）与6个月龄后癫痫发作时间显著相关。没有评估变量与癫痫缓解时间或6个月龄后癫痫的存在相关。
围产期卒中后儿童癫痫很常见。产前超声检查发现梗死的证据和癫痫家族史可预测癫痫发作更早出现。
