Risk Factors for Intractable Epilepsy in Children

2017 ◽  
Vol 14 (1) ◽  
pp. 25-30
Author(s):  
Mona Khalil
Keyword(s):  
Risk Factors ◽  
Intractable Epilepsy

Intractable Epilepsy: Etiology, Risk Factors and Treatment

1988 ◽  
Vol 19 (2) ◽  
pp. 68-73 ◽  
Author(s):  
A. Fois ◽  
D. Tomaccini ◽  
P Balestri ◽  
F Malandrini ◽  
M Vascotto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intractable Epilepsy

scholarly journals Postoperative Pneumocephalus on Computed Tomography Might Predict Post-Corpus Callosotomy Chemical Meningitis

2021 ◽  
Vol 11 (5) ◽  
pp. 638
Author(s):  
Ayataka Fujimoto ◽  
Keisuke Hatano ◽  
Toshiki Nozaki ◽  
Keishiro Sato ◽  
Hideo Enoki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Risk Factor ◽  
Intractable Epilepsy ◽  
Epileptic Seizures ◽  
Computed Tomography Scan ◽  
Corpus Callosotomy ◽  
Significant Difference ◽  
Chemical Meningitis ◽  
Tomography Scan

Background: A corpus callosotomy (CC) is a procedure in which the corpus callosum, the largest collection of commissural fibers in the brain, is disconnected to treat epileptic seizures. The occurrence of chemical meningitis has been reported in association with this procedure. We hypothesized that intraventricular pneumocephalus after CC surgery represents a risk factor for postoperative chemical meningitis. The purpose of this study was to analyze the potential risk factors for postoperative chemical meningitis in patients with medically intractable epilepsy who underwent a CC. Methods: Among the patients who underwent an anterior/total CC for medically intractable epilepsy between January 2009 and March 2021, participants were comprised of those who underwent a computed tomography scan on postoperative day 0. We statistically compared the groups with (c-Group) or without chemical meningitis (nc-Group) to determine the risk factors. Results: Of the 80 patients who underwent a CC, 65 patients (25 females and 40 males) met the inclusion criteria. Their age at the time of their CC procedure was 0–57 years. The c-Group (17%) was comprised of seven females and four males (age at the time of their CC procedure, 1–43 years), and the nc-Group (83%) was comprised of 18 females and 36 males (age at the time of their CC procedure, 0–57 years). Mann–Whitney U-tests (p = 0.002) and univariate logistic regression analysis (p = 0.001) showed a significant difference in pneumocephalus between the groups. Conclusion: Postoperative pneumocephalus identified on a computed tomography scan is a risk factor for post-CC chemical meningitis.

Topographical Risk Factor Analysis of New Neurological Deficits Following Precentral Gyrus Resection

Neurosurgery ◽  
2015 ◽  
Vol 76 (6) ◽  
pp. 714-720 ◽  
Author(s):  
Young-Hoon Kim ◽  
Chi Heon Kim ◽  
June Sic Kim ◽  
Sang Kun Lee ◽  
Jung Ho Han ◽  
...  
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Intractable Epilepsy ◽  
Neurological Impairment ◽  
Neurological Complications ◽  
Magnetic Resonance Images ◽  
Neurological Deficits ◽  
Cortical Lesion ◽  
Precentral Gyrus ◽  
Lower Quadrant

Abstract BACKGROUND: Precentral gyrus resections (PGRs) have been regarded as excessively hazardous interventions because of the risk of postoperative major neurological complications. OBJECTIVE: To evaluate the neurological deterioration that follows PGRs and to assess the topographical risk factors associated with these morbidities. METHODS: We reviewed 33 consecutive patients who experienced pharmacologically intractable epilepsy and underwent PGR with intraoperative cortical stimulation and mapping while under awake anesthesia. The etiological diagnoses were brain neoplasm in 26 patients (78.8%), cortical lesion in 4 (12.1%), and no lesion in 3 (9.1%). The mean follow-up period was 62.6 months (range, 12-146 months). All topographical analyses of the resected quadrant area were performed based on postoperative magnetic resonance images. RESULTS: After PGR, 22 patients (66.7%) experienced neurological worsening, including 5 permanent deficits (15.2%) and 17 transient deficits (51.5%). Permanent deficits included 2 instances of weakness, 1 dysarthria, 1 dysesthesia, and 1 fine-movement disturbance of the hand. While the neurological risk for anterior lower quadrant PGR was 20.0% (1/5), the risk for posterior upper quadrant PGR was 100.0% (10/10). The anterior upper and posterior lower quadrant PGR caused neurological deteriorations in 60.0% (6/10) and 62.5% (5/8) of the patients, respectively. In a multivariate analysis, PGR of the posterior and upper quadrant sections were significant risk factors for post-PGR neurological deteriorations (P = .022 and 0.030, respectively). CONCLUSION: The posterior upper quadrant of the precentral gyrus was vulnerable to post-resective neurological impairment.

scholarly journals Crossed Cerebellar Diaschisis: Risk Factors and Prognostic Value in Medically Intractable Epilepsy by 18F-FDG PET/CT

2020 ◽  
Author(s):  
Yaqin Hou ◽  
Kun Guo ◽  
Xiaotong Fan ◽  
Kun Shang ◽  
Jingjuan Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Fdg Pet ◽  
Poor Prognosis ◽  
Prognostic Value ◽  
Intractable Epilepsy ◽  
Temporal Lobes ◽  
Crossed Cerebellar Diaschisis ◽  
Pet Ct ◽  
Cerebellar Diaschisis ◽  
Fdg Pet Ct

Abstract Purpose Crossed cerebellar diaschisis (CCD) has been widely studied in hemispheric stroke but is less characterized in epilepsy. In this study, we used 18F-FDG positron emission tomography (PET)/computed tomography (CT) to investigate the risk factors for CCD and its prognostic value for intractable epilepsy. Methods One hundred medically intractable epilepsy patients pathologically diagnosed with focal cortical dysplasia (FCD) postoperatively were included and classified into two groups: CCD+ and CCD-. All patients underwent 18F-FDG PET/CT preoperatively. PET/CT images were analysed qualitatively by visual assessment and semi-quantitatively using the absolute asymmetry index (|AI|). Clinical factors, including age, sex, body mass index (BMI), age at seizure onset, epilepsy duration, seizure type, epilepsy severity, electroencephalography(EEG) and brain magnetic resonance imaging (MRI), were retrospectively assessed from medical records. Follow-up outcomes were evaluated according to the Engel classification at 3, 6, 12, 24 and 36 months postoperatively.Results Of the 100 patients, 77 (77%) were classified as CCD-, and 23 (23%) were classified as CCD+. CCD+ patients had a higher number of lobes involved on PET (3.61±2.16 vs 2.26±1.01, P<0.001) and more cases of occipital hypometabolism (21.74% vs 5.19%, P=0.03) than CCD- patients. CCD- patients showed more negative MRI results than CCD+ patients (P=0.02). Patients with a poor prognosis had more cases of parietal hypometabolism on PET (P=0.02). At 12 months postoperatively, 71%(29/41) of CCD- patients and 31%(4/13) of CCD+ patients presented a favourable prognosis (P=0.02). Significant differences in the average |AI| values in the posterior frontal and anterior temporal lobes were found between CCD+ and CCD- patients (P<0.05), but no significant correlation of the |AI| between supratentorial regions and the contralateral cerebellum was identified in CCD+ patients. Conclusion The number of lobes involved on PET, structural anomalies on MRI, the lesion location on PET, the |AI| values in the posterior frontal and anterior temporal lobes may be predisposing factors for CCD. CCD occurrence may help predict the prognosis of FCD patients at 12 months postoperatively, and parietal hypometabolism on PET may indicate a poor prognosis.

Readmission Following Surgical Resection for Intractable Epilepsy: Nationwide Rates, Causes, Predictors, and Outcomes

2018 ◽  
Vol 16 (3) ◽  
pp. 374-382 ◽  
Author(s):  
Kavelin Rumalla ◽  
Kyle A Smith ◽  
Paul M Arnold ◽  
Theodore H Schwartz
Keyword(s):  
Risk Factors ◽  
Hospital Readmissions ◽  
Diagnostic Testing ◽  
Multivariable Analysis ◽  
Intractable Epilepsy ◽  
International Classification Of Diseases ◽  
Median Income ◽  
Central Nervous System Complication ◽  
Discharge Disposition ◽  
Unique Predictor

Abstract BACKGROUND Hospital readmissions can be detrimental to patients and may interfere with the potential benefits of the therapeutic procedure. Government agencies have begun to focus on reducing readmissions; however, the etiology of readmissions is lacking. OBJECTIVE To report the national rates, risk factors, and outcomes associated with 30- and 90-d readmissions following surgery for intractable epilepsy. METHODS We queried the Nationwide Readmissions Database from January to September 2013 using International Classification of Diseases, Ninth Edition, Clinical Modification codes to identify all patients with intractable epilepsy, who underwent hemispherectomy (01.52), brain lobectomy (01.53), amydalohippocampectomy, or partial lobectomy (01.59). Predictor variables included epilepsy type, presurgical diagnostic testing, surgery type, medical complications, surgical complications, and discharge disposition. RESULTS In 1587 patients, the 30- and 90-d readmission rates were 11.5% and 16.8%, respectively. The most common reasons for readmission were persistent epilepsy, video electroencephalography monitoring, postoperative infection, and postoperative central nervous system complication. In multivariable analysis, risk factors associated with both 30- and 90-d readmission were Medicare payer status, lowest quartile of median income, depression, hemispherectomy, and postoperative complications (P &lt; .05). The only unique predictor of 30-d readmission was small bedsize hospital (P = .001). Readmissions within 30 d were associated with longer length of stay (6.8 vs 5.8 d), greater costs ($18 660 vs $15 515), and increased adverse discharges (26.4% vs 21.8%). CONCLUSION Following epilepsy surgery, most readmissions that occurred within 30 d can be attributed to management of persistent epilepsy and predicted by Medicare payer status, depression, and complications. These data can assist the clinician in preventing readmissions and assist policy makers determine which admissions are potentially avoidable.

scholarly journals Sudden cardiac death in epilepsy disappoints, but epileptologists keep faith

2016 ◽  
Vol 74 (7) ◽  
pp. 570-573 ◽  
Author(s):  
Fulvio A. Scorza ◽  
Esper A. Cavalheiro ◽  
Jaderson Costa da Costa
Keyword(s):  
Risk Factors ◽  
Sudden Cardiac Death ◽  
Cause Of Death ◽  
Cardiac Death ◽  
Seizure Control ◽  
Intractable Epilepsy ◽  
Sudden Unexpected Death ◽  
Unexpected Death ◽  
Common Cause ◽  
Preventative Measures

ABSTRACT Sudden unexpected death in epilepsy (SUDEP) is the most common cause of death in people with intractable epilepsy. Probably, optimization of seizure control will prevent some of these deaths. Briefly, we integrated in this paper some data about the epidemiology, risk factors, etiology, and preventative measures in the management of SUDEP.

scholarly journals Risk Factors in Childhood Intractable Epilepsy

2021 ◽  
Vol 27 (1) ◽  
pp. 78-83
Author(s):  
Dogan Oncu ◽  
◽  
Ayse Aysima Ozcelik ◽  
Saliha Seda Adanir ◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Intractable Epilepsy

Risk Factors for Developing Scoliosis in Cerebral Palsy: A Cross-Sectional Descriptive Study

2017 ◽  
Vol 32 (7) ◽  
pp. 657-662 ◽  
Author(s):  
Carlo M. Bertoncelli ◽  
Federico Solla ◽  
Peter R. Loughenbury ◽  
Athanasios I. Tsirikos ◽  
Domenico Bertoncelli ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Intractable Epilepsy ◽  
Female Gender ◽  
Descriptive Study ◽  
Hip Surgery ◽  
Cross Sectional ◽  
Severe Scoliosis ◽  
Children With Cerebral Palsy ◽  
History Of

This study aims to identify the risk factors leading to the development of severe scoliosis among children with cerebral palsy. A cross-sectional descriptive study of 70 children (aged 12-18 years) with severe spastic and/or dystonic cerebral palsy treated in a single specialist unit is described. Statistical analysis included Fisher exact test and logistic regression analysis to identify risk factors. Severe scoliosis is more likely to occur in patients with intractable epilepsy ( P = .008), poor gross motor functional assessment scores ( P = .018), limb spasticity ( P = .045), a history of previous hip surgery ( P = .048), and nonambulatory patients ( P = .013). Logistic regression model confirms the major risk factors are previous hip surgery ( P = .001), moderate to severe epilepsy ( P = .007), and female gender ( P = .03). History of previous hip surgery, intractable epilepsy, and female gender are predictors of developing severe scoliosis in children with cerebral palsy. This knowledge should aid in the early diagnosis of scoliosis and timely referral to specialist services.

scholarly journals Risk factors for childhood refractory epilepsy in a tertiary care centre, Chennai, India

2019 ◽  
Vol 6 (4) ◽  
pp. 1432
Author(s):  
Thannoli Gowthami Gowrinathan ◽  
Senthil Kumar A.
Keyword(s):  
Risk Factors ◽  
Chromosomal Abnormalities ◽  
Tertiary Care ◽  
Intractable Epilepsy ◽  
Febrile Seizures ◽  
Tertiary Care Centre ◽  
Male Preponderance ◽  
Symptomatic Epilepsy ◽  
Study Population ◽  
Active Epilepsy

Background: Intractable epilepsy is the pragmatic problem during the treatment of active epilepsy in children. Several risk factors are associated with incidence of intractable/recurrent epilepsy. The current study was done to identify the risk and prognostic factors associated with recurrent epilepsy (RE).Methods: This descriptive study was conducted on 152 children with idiopathic or symptomatic epilepsy who are on two or more AEDs and who were in follow up in Neurology OPD and inpatients in medical ward at ICH&HC, Chennai. All patients underwent relevant investigations to identify the possible risk factors for incidence of RE in study population. Karyotyping was done for idiopathic cases.Results: Male preponderance was seen in the study (M:F-2:1). Risk factors such as male sex, age onset of seizures, type of seizures, developmental delay, CNS congenital anomalies, h/o perinatal injury, neuroabnormality, abnormal MRI and EEG was found to have statistically significant association with incidence of RE. No significant association was observed for the factors microcephaly, behavioural abnormalities, h/o febrile seizures and h/o status epilepticus with incidence of RE. No chromosomal abnormalities were detected in idiopathic cases.Conclusions: Early identification, risk factor analysis and understanding in the dynamics of the disease helps the physician in initiating the appropriate treatment, thereby avoiding the wrong therapy, low dose therapy and infrequent therapy. Above all identification of the risk factors helps in parental counseling and prepare them for expected outcome.

Postoperative seizures after extratemporal resections and hemispherectomy in pediatric epilepsy

Neurology ◽  
2006 ◽  
Vol 66 (7) ◽  
pp. 1038-1043 ◽  
Author(s):  
J. Mani ◽  
A. Gupta ◽  
E. Mascha ◽  
D. Lachhwani ◽  
K. Prakash ◽  
...  
Keyword(s):  
Risk Factors ◽  
Epilepsy Surgery ◽  
Perioperative Complications ◽  
Intractable Epilepsy ◽  
Pediatric Epilepsy ◽  
Seizure Outcome ◽  
Table Analysis ◽  
Estimate Frequency ◽  
Postoperative Seizure

Objectives: To estimate frequency and risk factors for acute postoperative seizures (APOS) within the first week after extratemporal cortical resection (ETR) and hemispherectomy (HS) in children and to assess the predictive value of APOS on long-term seizure outcome in this group.Methods: The authors conducted a retrospective analysis of children (<18 years), who underwent ETR or HS for intractable epilepsy between 1995 and 2002. APOS features and seizure outcome after ETR or HS were obtained at 6, 12, and 24 months. Univariate logistic regression was used for risk factors of APOS and life table analysis and log rank tests for seizure outcome at 0 to 6, 6 to 12, and 12 to 24 months.Results: Of 132 patients, 34 (26%) had APOS. APOS were more frequent after ETR (26/71) than HS (8/61) (p < 0.01). APOS, irrespective of their timing, number, semiology, or other perioperative complications, were an independent predictor of poor postoperative seizure outcome at 2 years (p < 0.001). The estimated odds of postoperative Engel class I outcome in the APOS vs non-APOS categories was 0.27 (73% less likely) for 0- to 6-month, 0.22 (78% less likely) for 6- to 12-month, and 0.13 (87% less likely) for the 12- to 24-month intervals.Conclusions: Acute postoperative seizures (APOS) occur in 26% children, and the risk is higher after extratemporal cortical resection than hemispherectomy. APOS predict a poor postoperative seizure outcome at 6, 12, and 24 months. This study is useful for counseling families after epilepsy surgery. It also suggests that APOS may not be discounted as “benign” in research studies that evaluate seizure outcomes after epilepsy surgery.

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