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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Risk Factors of Post-Stroke Epilepsy in Children; Experience from a Tertiary Center and a Brief Review of the Literature
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Risk Factors of Post-Stroke Epilepsy in Children; Experience from a Tertiary Center and a Brief Review of the Literature

机译：儿童卒中后癫痫的危险因素; 来自第三节中心的经验以及对文献的简要审查

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Objectives: Acute seizures and post-stroke epilepsy have been reported more frequently in patients with pediatric stroke than adults. Acute seizures in the first days of a stroke may deteriorate stroke and ischemia-related neurodegeneration and contribute to the development of post-stroke epilepsy. In this study, we aimed to investigate risk factors for the development of post-stroke epilepsy in children with arterial ischemic stroke. Materials and Methods: We recruited 86 children with arterial ischemic stroke. We analyzed variables, including age at admission, gender, complaints at presentation, focal or diffuse neurologic signs, neurologic examination findings, laboratory investigations that were conducted at admission with stroke (complete blood cell count, biochemical-infectious-metabolic-immunological investigations, vitamin B12 levels, vitamin D levels), neuroimaging results, etiologies, time of the first seizure, time of remote seizures, and development of neurologic deficit retrospectively. Seizures during the first six hours after stroke onset were defined as 'very early seizures'. 'Early seizures' were referred to seizures during the first 48 h. Patients who experienced two or more seizures that occurred after the acute phase of seizures were classified as 'epileptic.' A binary logistic regression analysis was used to estimate risk factors. Results: An acute seizure was detected in 59% and post-stroke epilepsy developed in 41% of our cohort. Binary logistic regression analysis demonstrated that 'very early seizures' increased epilepsy risk six-fold. Epilepsy was 16 times higher in patients with 'early seizures'. Low vitamin D levels were defined as a risk factor for post-stroke epilepsy. Conclusion: Seizures in the very early period (within the first six hours) are the most significant risk factors for the development of post-stroke epilepsy Further studies regarding seizure prevention and neuroprotective therapies are needed because post-stroke epilepsy will affect long term prognosis in patients with pediatric stroke.
机译：目的：急性癫痫发作和卒中后癫痫在儿童卒中患者中比成人更常见。中风后第一天的急性发作可能会恶化中风和缺血相关的神经退行性变，并有助于中风后癫痫的发展。在这项研究中，我们旨在调查患有动脉缺血性卒中的儿童发生卒中后癫痫的危险因素。材料和方法：我们招募了86名患有动脉缺血性中风的儿童。我们分析了变量，包括入院时的年龄、性别、就诊时的投诉、局灶性或弥漫性神经症状、神经系统检查结果、中风入院时进行的实验室调查（全血细胞计数、生化感染代谢免疫学调查、维生素B12水平、维生素D水平）、神经影像学结果、病因、，回顾性分析首次发作时间、远程发作时间和神经功能缺损的发展。中风发作后6小时内的癫痫发作被定义为“极早期癫痫发作”“早期发作”指的是前48小时内的发作。发作急性期后出现两次或两次以上发作的患者被归类为“癫痫”二元逻辑回归分析用于估计危险因素。结果：59%的患者出现急性发作，41%的患者出现卒中后癫痫。二元逻辑回归分析表明，“非常早期癫痫发作”使癫痫风险增加六倍。“早期癫痫发作”患者的癫痫发病率高出16倍。低维生素D水平被定义为中风后癫痫的危险因素。结论：极早期（前6小时内）的癫痫发作是脑卒中后癫痫发生的最重要风险因素。由于脑卒中后癫痫会影响儿童脑卒中患者的长期预后，因此需要进一步研究癫痫预防和神经保护治疗。

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