Post-stroke epilepsy in Polish paediatric patients

Abstract

Aim: The aim of this study was to characterize a group of children with early and late remote seizures, which occurred after arterial ischaemic stroke (AIS), and to find predictors of post-stroke seizures. Method: The study group, recruited in the Department of Neuropediatrics (Medical University of Silesia, Katowice, Poland), comprised 78 individuals (range 1-18y) who had suffered a stroke: 13 participants had early seizures, occurring up to 7 days after AIS, seven participants had late remote seizures, occurring more than 7 days after AIS, and 58 participants had no seizures. Results: Post-stroke epilepsy occurred in 10 patients having post-stroke seizures. Participants affected by late remote seizures were younger, on average, than participants unaffected by seizures. The frequencies of total anterior circulation infarct (TACI) stroke subtype and focal cerebral arteriopathy (FCA) were significantly higher in the late seizure subgroup than in the subgroup without seizures (71% vs 26%, p=0.014, OR 7.17, and 100% vs 51%, p=0.015 respectively). Multivariable Cox analysis showed that age at time of stroke (p=0.027), FCA (p=0.010), and the number of infarct foci (p<0.001) were significant predictors of post-stroke seizures. Interpretation: Age at time of stroke, presence of FCA, and number of infarct foci are predictors of post-stroke seizures in Polish paediatric patients. What this paper adds: Demonstrates that focal cerebral arteriopathy may be a predictor of post-stroke seizures. Shows that age at time of stroke and the number of infarct foci are related to post-stroke seizures. Data indicate that the total anterior circulation infarct stroke subtype may be a predictor of late remote seizures. Suggests that children with late remote post-stroke seizures are more likely to have cognitive disabilities.