Breitweg Ina, Stülpnagel Celina von, Pieper Tom, Lidzba Karen, Holthausen Hans, Staudt Martin, Kluger Gerhard
Clinic for Neuropediatrics and Neurorehabilitation, Epilepsy Center for Children and Adolescents, Schön Klinik, Krankenhausstr. 20, D-83569 Vogtareuth, Germany; Department of Epileptology, Children's Center Munich, Center for Social Pediatrics, Heiglhofstr. 63, D-81377 Munich, Germany.
Clinic for Neuropediatrics and Neurorehabilitation, Epilepsy Center for Children and Adolescents, Schön Klinik, Krankenhausstr. 20, D-83569 Vogtareuth, Germany; Paracelsus Medical University, Strubergasse 21, A-5020 Salzburg, Austria.
Eur J Paediatr Neurol. 2017 May;21(3):465-467. doi: 10.1016/j.ejpn.2016.12.007. Epub 2016 Dec 18.
To identify risk factors for the development of epilepsy after pediatric stroke.
Retrospective analysis of hospital charts of 93 children and adolescents with post-neonatal non-traumatic stroke and a minimum follow-up of two years. Seizures during the first 48 h after onset of stroke symptoms were defined as "early seizures"; when two or more seizures occurred after this period, the patient was classified as "epileptic".
Early seizures, young age at stroke and MRI evidence of cortical involvement were observed more frequently in the children who developed epilepsy. These factors were, however, significantly interrelated; a stepwise multiple regression analysis in 46/93 patients with complete datasets identified only the occurrence of early seizures as a significant risk factor: 15/19 (79%) children with early seizures developed epilepsy, as opposed to only 7/53 (13%) without early seizures.
Children with stroke who show seizures during the first 48 h after onset of stroke symptoms have a high risk to develop post-stroke epilepsy, whereas in children without early seizures, post-stroke epilepsy is rare.
确定小儿卒中后癫痫发生的危险因素。
回顾性分析93例新生儿期后非创伤性卒中儿童及青少年的医院病历，且至少随访两年。卒中症状发作后最初48小时内的癫痫发作定义为“早期癫痫发作”；在此期间后发生两次或更多次癫痫发作时，患者被归类为“癫痫患者”。
癫痫患儿中早期癫痫发作、卒中时年龄小以及MRI显示皮质受累的情况更为常见。然而，这些因素之间存在显著相关性；对46/93例有完整数据集的患者进行逐步多元回归分析，结果仅显示早期癫痫发作的发生是一个显著的危险因素：19例有早期癫痫发作的儿童中有15例（79%）发生癫痫，而53例无早期癫痫发作的儿童中只有7例（13%）发生癫痫。
卒中症状发作后最初48小时内出现癫痫发作的儿童发生卒中后癫痫的风险很高，而无早期癫痫发作的儿童卒中后癫痫很少见。
