Epilepsy in children with Meningomyelocele

Talwar, Dinesh; Baldwin, Marjorie A.; Horbatt, Cathy I.

doi:10.1016/0887-8994(95)00088-w

Cited by 36 publications

(23 citation statements)

References 7 publications

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“…The mortality rate was relatively low despite delays in correcting the NTD, thanks to the use of prophylactic antibiotic 20,22 . The association of epilepsy and myelomeningocele in the present study was probably related to the presence of VPS that compensates Arq Neuropsiquiatr 2004;62 (4) 967 for hydrocephalus, plus previous episodes of meningitis, also mentioned by other authors [23][24][25] .…”

mentioning

confidence: 50%

Myelomeningocele: a Brazilian University Hospital experience

Ulsenheimer

Antoniuk

Santos

et al. 2004

Arq. Neuro-Psiquiatr.

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We analyzed 31 children with myelomeningocele born between July 1990 and July 2000. Follow-up median was 24 months (6-68months). Only 2 mothers had a known etiologic factor (diabetes mellitus). Twelve had the correct prenatal diagnosis. All children were born at term; 23 by cesarean; 13 had rupture of the membrane. Surgical correction had a 4 days median (1 to 44 days). Lumbosacral lesions were the most frequent (46%). Thirty patients were hydrocephalic, shunt was placed in 27. Meningitis was 4 times more frequent in shunted patients. Seven became epileptic (19.4%). Denver II test showed significant delay in gross motor development . Neurogenic bladder was diagnosed in 12 patients. Congenital clubfoot was the main orthopedic malformation (53%). Six infants died. Nowadays, 17 patients are being followed. A multidisciplinary approach probably helps for a better quality of life.

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mentioning

confidence: 50%

Myelomeningocele: a Brazilian University Hospital experience

Ulsenheimer

Antoniuk

Santos

et al. 2004

Arq. Neuro-Psiquiatr.

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“…many others [17,24,23] that there is an increased risk of seizures in patients with CNS malformations, while only Copeland et al [6] were not able to convince their readers that there was a correlation between pathologic conditions causing hydrocephalus and the incidence of seizures. Mental retardation is another factor that aggravates the risk of having or developing seizures.…”

Section: Discussionmentioning

confidence: 99%

Hydrocephalus and epilepsy

Sato¹,

Yamguchi²,

Kittaka³

et al. 2001

Child's Nervous System

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Since the introduction of ventriculo-atrial and/or ventriculo-peritoneal shunting for hydrocephalic patients, controversies have developed regarding the likelihood of epileptic seizures developing as a result of the shunting itself and/or its complications. On the other hand, hydrocephalus is not commonly recognized as a cause of seizures in general, although epilepsy is reported to be frequently associated with shunt-treated hydrocephalus, especially in children. Several authors have reported an increased risk of epileptic seizures after shunt placement, but the underlying mechanisms are still controversial. The insult to the brain at the time of ventricular catheter insertion, the presence of the shunt tube itself as a foreign body, the burr hole location, the number of shunt revisions after malfunction, associated infection, the etiology of hydrocephalus, and associated mental retardation are thought to be related to the risk of epilepsy. Age at the time of initial shunt placement also seems to be an important factor. Early shunting is a well-known determinant of risk in shunt obstruction, and children less than 2 years old are consequently at a higher risk of developing epilepsy than older ones. It is reported that antiepileptic drug treatment is not so reliable as might be expected. Conscientious and more sophisticated EEG recording in those children may be beneficial during follow-up. The incidence of seizures in shunted children is reported to be quite high, ranging from 20% to approximately 50%, so that neurosurgeons should pay more attention to the issue of epilepsy in hydrocephalic children. Although ventriculo-extracranial shunts have been the standard treatment for hydrocephalus for decades, the long-term morbidity, including postshunt epileptic seizures, has to be taken seriously. The use of neuroendoscopic techniques when indicated may ameliorate this problem a great deal in the future.

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“…In previous studies, the type of complication, namely shunt malfunction and shunt infection, has also been focused on. With some exceptions [3,4,10], most authors concluded that shunt infection increases the probability of developing epilepsy [5,6,13,20,22,24,25,26,27]. Also, in contrast to authors who believed in a relation between shunt malfunction and epilepsy [6,11,28,29], others did not believe in it [1].…”

Section: Discussionmentioning

confidence: 83%

Seizure Risk Factors in Shunted Hydrocephalic Patients

Majed¹,

Andrabi²,

Nejat³

et al. 2012

Pediatr Neurosurg

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Objective: There are controversies about seizure risk factors in shunted hydrocephalic patients which can be due to having merged two different types of seizure (preshunt and postshunt seizures) in previous studies. Also, it is not known whether a considerable change in ventricular size after shunting can be a risk factor of postshunt seizures. Methods: 150 hydrocephalic patients who underwent shunting from 2006 to 2011 in the Children's Hospital Medical Center in Tehran, Iran, were visited at least 1 year after shunting to assess risk factors of preshunt and postshunt seizures. Ventricular size was assessed by using a radiologic index of bifrontal ratio (BFR). Results: Preshunt seizures were higher in patients with postinfectious hydrocephalus and intraventricular hemorrhage. Early shunting, history of shunt complications and shunt infection, and a high number of shunt revisions were significant risk factors for developing postshunt seizures. The change in BFR after shunting was not a significant risk factor of postshunt seizures. Conclusion: The difference between risk factors of preshunt seizures and postshunt seizures shows that they are two different types of seizures with different natures. Preshunt seizures are hard to prevent as they are related to the underlying disease of the brain or the etiology of hydrocephalus. However, postshunt seizures are related to the shunt and might be decreased by preventing shunt complications.

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Epilepsy in children with Meningomyelocele

Cited by 36 publications

References 7 publications

Myelomeningocele: a Brazilian University Hospital experience

Myelomeningocele: a Brazilian University Hospital experience

Hydrocephalus and epilepsy

Seizure Risk Factors in Shunted Hydrocephalic Patients

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