Structural epilepsy in children who have suffered a hemorrhagic stroke

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Abstract

The relevance of studying the consequences of hemorrhagic strokes in young children is due to the frequency of cerebrovascular pathology, the formation of persistent neurological deficits, including post-stroke epilepsy, and high mortality. It is known that hemorrhages are diagnosed in the first 28 days of life in 6-7 out of 100,000 infants, in children from the 28th day of life to 18 years of age from 0.7 to 5.1 cases per 100 thousand children. Mortality in hemorrhagic and ischemic strokes in children ranges from 7 to 28%. Epileptic seizures of the acute and acute period of stroke are prognostically unfavorable factors of the course of the disease. The article presents brief literature data on the etiology and localization of hemorrhagic strokes, their role in the formation of pharmacoresistant epilepsy. Special attention is paid to the role of late hemorrhagic disease of newborns, accompanied by intracranial hemorrhages, in the formation of structural epilepsy in the future. The paper describes own clinical observations of 25 patients suffering from epilepsy after a hemorrhagic stroke with a description of the clinical picture, features of paroxysmal states and their therapy, neuroimaging data, electroencephalographic phenomena. A clinical example is presented in which the clinical, anamnestic, electrophysiological data of a patient with pharmacoresistant epilepsy developed as a result of a hemorrhagic stroke on the background of late hemorrhagic disease of newborns are considered.

Structural epilepsy in children, formed after a hemorrhagic stroke, is accompanied by significant multi-regional damage, pronounced neurological deficit and is characterized by a pharmacoresistant course.

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About the authors

Maria Yu. Fomina

St. Petersburg State Pediatric Medical University

Author for correspondence.
Email: myfomina@mail.ru

MD, PhD, Dr. Med. Sci., Professor of Department of Neonatology with Courses of Neurology and Obstetrics-Gynecology

Russian Federation, Saint Petersburg

Helena V. Gumenik

St. Olga Children's City Hospital

Email: helenneurol@mail.ru

MD, PhD, Associate Professor, Head of City Office for the Treatment of Epilepsy and Paroxysmal Conditions

Russian Federation, Saint Petersburg

Dmitry D. Korostovtsev

St. Petersburg State Pediatric Medical University

Email: korostovtsevdmitry@gmail.com

MD, PhD, Associate Professor, Head of Consulting and Diagnostic Center

Russian Federation, Saint Petersburg

Marina V. Kovelenova

EPIJAY Pediatric Neurology and Epileptology Clinic

Email: mkovelenova@yahoo.com

MD, PhD, Associate Professor, Head

Russian Federation, Saint Petersburg

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Supplementary files

Supplementary Files
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1. Fig. 1. MRI of a patient М. Coronary sections, T2 VI. Leukoencephalomalacia of the right hemisphere and parasagittal parts of the left frontal lobe

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2. Fig. 2. MRI of a patient. Axial sections, T1 VI, T2 VI, Flair. the cystic-atrophic changes in the right hemisphere

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Copyright (c) 2022 Fomina M.Y., Gumenik H.V., Korostovtsev D.D., Kovelenova M.V.

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