The Incidence of Seizure Disorder in Children with Acquired and Congenital Hydrocephalus

Stellman, Gillian R.; Bannister, Carys M.; Hillier, V.

doi:10.1055/s-2008-1043396

Cited by 15 publications

(22 citation statements)

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“…The most important shunt-related variables in this study are shunt complications (infection) and shunt revisions. In contrast to some studies that did not find any relation [1,3,4,7,10,22], others showed that shunt complications and shunt revisions increase the incidence of seizures in shunted patients [5,6,11,21,22,23,24] so that shunt complications are considered to be responsible for large numbers of seizures [22]. Bourgeois et al [5] showed that the incidence of seizures was higher in patients with shunt complications.…”

Section: Discussioncontrasting

confidence: 41%

“…Also, a family history was not a significant risk factor in this study as in the report of Noetzel and Blake [4]. Some studies failed to find a role for etiology of hydrocephalus in seizure development in shunted patients [10,20,21,22] while the majority of authors have shown that the frequency of seizures in spina bifida and myelomeningocele patients is much lower than the risk in patients with hydrocephalus secondary to hemorrhage, trauma, or infection [3,4,5,7,11,23,24,25]. Heinsbergen et al [23], in a retrospective study of 119 shunted patients, showed that among etiologic factors, the odds ratio of developing seizure is 2.5 for hemorrhage and 2.3 for infection while it is 0.3 for spina bifida.…”

Section: Discussionmentioning

confidence: 47%

“…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: 81%

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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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Section: Discussioncontrasting

confidence: 41%

Section: Discussionmentioning

confidence: 47%

Section: Discussionmentioning

confidence: 81%

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Seizure Risk Factors in Shunted Hydrocephalic Patients

Majed¹,

Andrabi²,

Nejat³

et al. 2012

Pediatr Neurosurg

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“…Mental retardation was diagnosed four times as frequently in children with seizures [18]. Children with IQ scores of 70 or below were more likely to experience seizures than were children with normal intelligence [22], and furthermore in children with meningomyelocele mental retardation was statistically more common when associated with seizures, regardless of the presence or absence of hydrocephalus [17].…”

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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“…Shunt infections are associated with higher rates of revision, recurrence of infection, ventriculitis, meningitis, and encephalitis, and often with greater mortality rates (Winston, Ho & Dolan 2013). Complications include loss of intelligence quotient (IQ) and increased seizure risk, both of which occur via mechanisms that have yet to be defined (Vinchon, Dhellemmes 2006, Sato et al 2001, Stellman, Bannister & Hillier 1986, Chadduck, Adametz 1988). This may be due to neuronal death as a direct result of infection or may be a consequence of inflammation within the central nervous system (CNS) due to the infection.…”

Section: Introductionmentioning

confidence: 99%

Ventricular shunt infections: Immunopathogenesis and clinical management

Gutierrez-Murgas

Snowden

2014

Journal of Neuroimmunology

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Ventricular shunts are the most common neurosurgical procedure performed in the United States. This hydrocephalus treatment is often complicated by infection of the device with biofilm-forming bacteria. In this review, we discuss the pathogenesis of shunt infection, as well as the implications of the biofilm formation on treatment and prevention of these infections. Many questions remain, including the contribution of glia and the impact of inflammation on developmental outcomes following infection. Immune responses within the CNS must be carefully regulated to contain infection while minimizing bystander damage; further study is needed to design optimal treatment strategies for these patients.

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The Incidence of Seizure Disorder in Children with Acquired and Congenital Hydrocephalus

Cited by 15 publications

References 0 publications

Seizure Risk Factors in Shunted Hydrocephalic Patients

Seizure Risk Factors in Shunted Hydrocephalic Patients

Hydrocephalus and epilepsy

Ventricular shunt infections: Immunopathogenesis and clinical management

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