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

References

  1. Bazilevich SN, Odinak MM, Dyskin DE, Krasakov IV, at al. The structural and functional neurovisualization in patients with epileptic seizures in cerebro-vascular diseases. SS Korsakov Journal of Neurology and Psychiatry. 2008;(S2):33–40. (In Russ.)
  2. Gext AB, Tlapshkova LB, Lebedeva AV. Post-stroke epilepsy. SS Korsakov Journal of Neurology and Psychiatry. 2000;(9):67–70. (In Russ.)
  3. Degtyarev DN, Karpova AL, Mebelova II. Klinicheskie rekomendatsii po diagnostike i lecheniyu gemorragicheskoi bolezni novorozhdennykh. Moscow. 2015. 21 p. (In Russ.)
  4. Zaplatnikov AL, Brazhnikova OV, Medoev SB, at al. Intracranial hemorrhages in late hemorrhagic disease of the newborns. Pediatriya. Consilium Medicum. 2019;(4):14–17. (In Russ.) doi: 10.26442/26586630.2019.4.190755
  5. Ivanov DO. History of the study of hemorrhagic disease of newborns. Pediatrician (St. Petersburg). 2017;8(4): 118–125. (In Russ.) doi: 10.17816/PED84118-125
  6. Ivanov DO, Atlasov VO, Bobrov SA, et al. Rukovodstvo po perinatologii. Saint Petersburg: Inform-Navigator; 2015. 1214 p. (In Russ.)
  7. Ivanov DO, Kozlova LV, Derevcov VV. Neuropsychiatric development of children in the first 6 months of life born with fetus growth delay. Pediatrician (St. Petersburg). 2017;8(1):40–49. (In Russ.) doi: 10.17816/PED8140-49
  8. Kuznecova AA, Shchederkina IO, Livshic MI, et al. Hemorrhagic stroke and post-stroke epilepsy in children. An individual approach to the choice of management tactics on the example of clinical observation. Pediatric Neurosurgery and Neurology. 2021;(1):22–34. (In Russ.)
  9. Lyapin AP, Kasatkina TP, Rubin AN, et al. Intracranial hemorrhages as a manifestation of late hemorrhagic disease of newborns. Pediatriya. 2013;(2):38–42. (In Russ.)
  10. Spirin AL, Trashkov AP, Cygan NV, et al. Supratentorial сerebral hemorrhage: pathophysiologic criteria and tactics of treatment. Pediatrician (St. Petersgurg) 2015;6(1): 96–104. (In Russ.) doi: 10.17816/PED6196-104
  11. Shabalov NP, Ivanov DO, Shabalova NN. Dynamic of hemostasis in first week of life as reflection of adaptive mechanisms to extrauterine life. Pediatrics. Journal Named After GN. Speransky. 2000;79(3):84–91. (In Russ.)
  12. Shchederkina IO, Zavadenko NN, Koltunov IE. Epilepsy in children with stroke. Epilepsy and Paroxysmal Conditions. 2015;7(4):66–71. (In Russ.)
  13. Benbadis S. The differential diagnosis of epilepsy. Epilepsy & Behavior. 2009;15(1):15–21. doi: 10.1016/j.yebeh.2009.02.024
  14. Beslow LA, Abend NS, Gindville MC, et al. Intracerebral Hemorrhage Locations and Etiologies. JAMA Neurol. 2013;70(4):448–454. doi: 10.1001/jamaneurol.2013.1033
  15. Beslow LA, Dowling MM, Hassanein SM, et al. Mortality After Pediatric Arterial Ischemic Stroke. International Pediatric Stroke Study Investigators. Pediatrics. 2018;141(5): 2017–4146. doi: 10.1542/peds.2017-4146
  16. Billinghurst LL, Beslow LA, Abend NS, et al. Incidence and predictors of epilepsy after pediatric arterial ischemic stroke. Neurology. 2017;88(7):630–637. doi: 10.1212/WNL.0000000000003603
  17. Bladin CF, Alexandrov AV, Bellavance A, et al. Seizures after stroke: a prospective multicenter study. Arch Neurol. 2000;57(11):1617–1622. doi: 10.1001/archneur.57.11.1617
  18. Fisher RS, Acevedo C, Arzimanoglou A, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia. 2014;55(4):475–482. doi: 10.1111/epi.12550
  19. Fox Christine K, Glass Hannah C, Sidney Stephen, et al. Acute seizures predict epilepsy after childhood stroke. Ann Neurol. 2013;74(2):249–256. doi: 10.1002/ana.23916
  20. Haapaniemi E, Strbian D, Rossi C. The CAVE score for predicting late seizures after intracerebral hemorrhage. Stroke. 2014;45(7):1971–1976. doi: 10.1161/STROKEAHA.114.004686
  21. Holtkamp M, Beghi E, Benninger F, et al. European Stroke Organisation guidelines for the management of post-stroke seizures and epilepsy. Eur Stroke J. 2017;2(2): 103–115. doi: 10.1177/2396987317705536
  22. Jordan LC. Assessment and treatment of stroke in children. Current Treatment Options in Neurology. 2008; 10(6):399–409. doi: 10.1007/s11940-008-0042-9
  23. Puckett RM, Offringa M. Prophylactic vitamin K for vitamin K deficiency bleeding in neonates. Review Cochrane Database Syst Rev. 2000;2000(4):CD002776. doi: 10.1002/14651858.CD002776
  24. Yinghao Z, Li X, Zhang K, Ting T. The Progress of Epilepsy after Stroke. Current Neuropharmacology. 2018;16(1): 71–78. doi: 10.2174/1570159X15666170613083253

Supplementary files

Supplementary Files
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1. JATS XML
2. 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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3. 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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