The Incidence of Epilepsy after Ventricular Shunting Procedures

Dan, Noel G.; Wade, Megan J.

doi:10.1007/978-3-662-11149-9_69

Cited by 2 publications

(6 citation statements)

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“…Of patients with a parietal ventricular catheterization site only 6.6% had convulsions, in contrast to 54.5% of those with a frontal site [7].…”

Section: Discussionmentioning

confidence: 79%

“…EEG findings and seizure types observed in hydrocephalus with shunt and without shunt were documented in the reviewed papers [1,16], and additional findings have been well described in the literature [4,7,8,13,21]. Graebner and Celesia [9] stated that 62% of subjects in the nonshunted group and 85% in the shunted group had abnormal EEGs, and focal specific paroxysmal discharges were present in 38% in the shunted group, in contrast to only 10% in the nonshunted group.…”

Section: Discussionmentioning

confidence: 81%

“…Eight percent of the patients studied by Klepper et al [16] developed epilepsy before shunt implantation, and 12% of them, after shunting; onset of epilepsy peaked within 6 months of the shunting procedure. On the other hand, none of the study group had experienced seizures prior to shunt placement and the risk of seizures fell from 5% in the 1st year after shunting to 1.1% after the 3rd year [7]. With respect to the time to onset of epilepsy the results varied from 24 h to 3 years, but 58% of those who developed seizures had their first seizure within the 1st month following shunt surgery [6].…”

Section: Discussionmentioning

confidence: 93%

“…However, the prognosis of the seizures is somewhat different from that reported by others in children with hydrocephalus after meningomyelocele, and in these subjects three-quarters had antiepileptic medication discontinued without recurrence of sei-zures and some others were well controlled with medication [17]. The debate continues on prophylactic use of AEDs, Dan and Wade [7] remaining unconvinced while Copeland et al [6] conclude that prophylactic use of AEDs is probably indicated for a minimum of 1 year.…”

Section: Discussionmentioning

confidence: 96%

“…The need for more frequent valve revisions appeared to increase that tendency [12]. And there is very persuasive evidence to suggest a significant correlation between the frequency of revisions and the occurrence of seizures, as only 5.9% of those who did not have a catheter revision developed epilepsy, compared with 24.2% of those with two or more proximal side revisions [7]. Chadduck and Adametz [5] described increased risk of seizures (22%) in the patients who had required subsequent shunt malfunction in comparison with the incidence(9%) in the patients who had not.…”

Section: Discussionmentioning

confidence: 99%

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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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“…Of patients with a parietal ventricular catheterization site only 6.6% had convulsions, in contrast to 54.5% of those with a frontal site [7].…”

Section: Discussionmentioning

confidence: 79%