Ghosh Suman, Philip Joseph, Patel Nikita, Munoz-Pareja Jennifer, Lopez-Colon Dalia, Bleiweis Mark, Winesett Steven Parrish
Division of Pediatric Neurology, University of Florida, Gainesville, FL, USA.
University of Florida Congenital Heart Center, Gainesville, FL, USA.
J Child Neurol. 2020 Jun;35(7):442-447. doi: 10.1177/0883073820904912. Epub 2020 Feb 27.
To identify potential risk factors for pre- and postoperative seizures and epilepsy in children with congenital heart disease.
Retrospective cohort study of neonates and infants <3 months of age with congenital heart disease who underwent cardiopulmonary bypass from November 24, 2006, until June 1, 2015. Children with seizures were classified based on time of occurrence into early preoperative, early postoperative, and late postoperative. Children with recurring seizures 30 days after cardiac surgery met criteria for epilepsy.
247 patients completed follow-up; 2.4% had seizures early preoperation and 1.6% early postoperation. Late postoperative epilepsy occurred in 5.3% of the cohort. The majority of seizures in the late postoperative epilepsy group started after 1 year of age (mean 1.53 years, range = 0.18-4.7 years). One of the 13 patients with epilepsy had a seizure during their intensive care unit hospitalization. Potential risk factors for seizures included brain injury ( < .001), high-risk surgery (Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery score ≥3, = .024), and low birth weight ( < .04). Infants with stroke were more likely to develop epilepsy ( = .04). Presence of seizures was associated with increased length of stay ( < .001).
Our study suggests an association between children with congenital heart disease diagnosed with stroke in the neonatal/infancy period and the development of epilepsy. These children may not have prior early pre- and postoperative seizures. Risk factors for seizures include brain injury, high-risk surgery, and lower birth weight. Seizures were associated with an increased length of stay but did not necessarily lead to subsequent epilepsy.
确定先天性心脏病患儿术前和术后癫痫发作及癫痫的潜在危险因素。
对2006年11月24日至2015年6月1日期间接受体外循环的3个月龄以下先天性心脏病新生儿和婴儿进行回顾性队列研究。癫痫发作患儿根据发作时间分为术前早期、术后早期和术后晚期。心脏手术后30天内反复癫痫发作的患儿符合癫痫标准。
247例患者完成随访；2.4%在术前早期出现癫痫发作，1.6%在术后早期出现。5.3%的队列出现术后晚期癫痫。术后晚期癫痫组的大多数癫痫发作始于1岁以后（平均1.53岁，范围=0.18 - 4.7岁）。13例癫痫患者中有1例在重症监护病房住院期间发作。癫痫发作的潜在危险因素包括脑损伤（P<0.001）、高风险手术（胸外科医师协会-欧洲心胸外科学会评分≥3，P = 0.024）和低出生体重（P<0.04）。中风婴儿更易发生癫痫（P = 0.04）。癫痫发作与住院时间延长相关（P<0.001）。
我们的研究表明，新生儿/婴儿期诊断为中风的先天性心脏病患儿与癫痫的发生有关。这些患儿术前和术后早期可能没有癫痫发作。癫痫发作的危险因素包括脑损伤、高风险手术和较低出生体重。癫痫发作与住院时间延长相关，但不一定导致随后的癫痫。
