Early Seizures Predict the Development of Epilepsy in Children and Adolescents with Stroke

Purpose: To identify risk factors for the development of epilepsy after pediatric stroke.Methods: Retrospective analysis of hospital charts 0193 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".Results: 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.Conclusion: 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. (C) 2016 Published by Elsevier Ltd on behalf of European Paediatric Neurology Society.