Children with post-stroke epilepsy have poorer outcomes one year after stroke. Issue 8 (October 2018)

• Record Type: Journal Article
• Authors: Fox, Christine K; Jordan, Lori C; Beslow, Lauren A; Armstrong, Jennifer; Mackay, Mark T; deVeber, Gabrielle
• Is Part Of: International journal of stroke. Volume 13:Issue 8(2018)
• Page Start: 820
• Page End: 823
• Publication Date: 2018-10
• Subjects: Ischemic stroke -- risk factors -- seizures -- pediatric -- outcomes -- neurology; 616.8005
• DOI: 10.1177/1747493018784434
• Languages: English
• ISSNs: 1747-4930

Abstract

Background: Epilepsy is a common complication of pediatric stroke. Aim: In this study, we aim to measure the association between epilepsy and neurologic outcome after childhood arterial ischemic stroke. Methods: Prospective cohort study of children (29 days–19 years) enrolled after an acute arterial ischemic stroke at 21 international pediatric stroke centers and followed to identify epilepsy. One year post-stroke, outcomes were scored using the examination-based Pediatric Stroke Outcome Measure (range = 0–10); higher values reflect greater disability. Ordinal logistic regression was used to measure the association of Pediatric Stroke Outcome Measure scores (categorized as 0–1, 1.5–3, 3.5–6, 6.5–10) with epilepsy. Results: Investigators enrolled 86 children (median age = 6.1 years, interquartile range (IQR) = 1.4–12.2 years) with acute stroke. At 1 year, 18/80 (23%) remained on an anticonvulsant including 8/80 (10%) with epilepsy. Among the 70 with Pediatric Stroke Outcome Measure scored, the median was 0.5 (IQR = 0–1.5) for children without epilepsy ( n = 63), and 6 (IQR = 0.5–10) for children with epilepsy ( n = 7). In univariable analyses, poorer 1-year outcome was associated with middle cerebral artery stroke, cortical infarcts, hemorrhagic transformation, hospital disposition not to home, and epilepsy. In multivariable analysis, middle cerebral artery stroke (odds ratio (OR) = 4.9, 95% confidence intervals (CI) = 1.1–21.3) and epilepsy (OR = 24.1, CI = 1.5–380) remained associated with poorer outcome. Conclusions: Children who developed epilepsy during the first year post-stroke had poorer neurologic outcomes than those without epilepsy.