Analysis Of Clinical Features Of Early Post-stroke Seizure In Children

Objective: To summarize the clinical features of early post-stroke seizure in children and to explore the risk factors of early post-stroke seizure and post-stroke epilepsy in children.Methods: Collect the clinical data of stroke patients admitted to Children’s Hospital of Chongqing Medical University,from January 2012 to September 2019,and conduct follow-up by telephone or outpatient,to analyze the risk factors of early post-stroke seizure and post-stroke epilepsy in children.Result:1.A total of 116 children with stroke were included,and 58 patients(50.0%)had early post-stroke seizure.Early post-stroke seizures mostly occur in children from 1 month to 3 years old(51/58,87.9%),with a male to female ratio of 1.32:1.2.Most early post-stroke seizure(40/58,69.0%)occurred within 24 hours after stroke.Multiple seizures occurred mostly,and single seizure only occurred in 10(25%)cases.The seizure type of early post-stroke seizure were focal in 32/58(55.2%)children.9(15%)had status epilepticus.EEG recording during acute phases after stroke showed slowing waves background in 13(28.8%)cases,and epileptiform discharge were found in 8(17.8%)cases.3.In the group with early post-stroke seizure with hemorrhagic stroke,cerebral cortical hemorrhage was the most(26/34,76.5%),followed by subarachnoid hemorrhage(5/34,14.7%).In the group with early post-stroke seizure with ischemic stroke,cerebral ischemia was the most common(18/24,75.0%),followed by basal ganglia ischemia(6/24,25.0%).4.The independent risk factors for early post-stroke seizure in children were determined to be young age(OR=40.807,95%CI=11.411-145.934)and cortical stroke(OR=10.278,95%CI=2.437-43.345).Among the 63 children successfully followed up,7 children(11.1%)developed as post-stroke epilepsy,and bilateral stroke was a independent risk factor for post-stroke epilepsy(OR=6.022,95 %CI=1.048-34.591).5.In children with early early post-stroke seizure,antiepileptic drug therapy has no statistically significant influence in the long-term development of post-stroke epilepsy(P>0.05).Conclusion:1.Post-stroke seizures are common in childhood stroke,which mostly occur in infancy and early childhood.Most of them occur within 24 hours after stroke.2.The seizure type of early post-stroke seizure were mostly focal onset.EEG recording during acute phases after stroke showed slowing waves background mainly.3.Young age and cortical stroke were independent risk factors for early seizures after stroke,and bilateral stroke is independent risk factors for PSE.4.For children with early Post-stroke seizures,AEDs do not need to be taken regularly,but for children with repetitive seizures,AEDs is required.