Risk factors for acute symptomatic seizure in children with cerebral sinovenous thrombosis: Experience from a tertiary center.

Autor: Yücel G; Department of Pediatric Neurology, Faculty of Medicine, Inönü University, Malatya, Turkey. Electronic address: drgulyucel@hotmail.com., Arslan AK; Department of Biostatistics and Medical Informatics, Faculty of Medicine, Inönü University, Malatya, Turkey. Electronic address: ahmetkadirarslan@gmail.com., Özgör B; Department of Pediatric Neurology, Faculty of Medicine, Inönü University, Malatya, Turkey. Electronic address: drbilge.ozgor@gmail.com., Şahin MÇ; Department of Pediatrics, Faculty of Medicine, Inönü University, Malatya, Turkey. Electronic address: muratcaglarsahin@gmail.com., Öncül Y; Department of Pediatric Hematology and Oncology, Faculty of Medicine, Inönü University, Malatya, Turkey. Electronic address: dr-yurday@hotmail.com., Taşolar SD; Department of Pediatric Radiology, Faculty of Medicine, Inonu University, Malatya, Turkey., Akyay A; Department of Pediatric Hematology and Oncology, Faculty of Medicine, Inönü University, Malatya, Turkey. Electronic address: akyay@hotmail.com., Güngör S; Department of Pediatric Neurology, Faculty of Medicine, Inönü University, Malatya, Turkey. Electronic address: gungorserdal@yahoo.com.
Jazyk: angličtina
Zdroj: Clinical neurology and neurosurgery [Clin Neurol Neurosurg] 2024 Nov; Vol. 246, pp. 108571. Date of Electronic Publication: 2024 Sep 23.
DOI: 10.1016/j.clineuro.2024.108571
Abstrakt: Objective: To investigate the risk factors for acute symptomatic seizure (ASS) in children with Cerebral Sinovenous Thrombosis (CSVT) and to evaluate the effect of ASS on outcome.
Methods: Cross-sectional, single-center, hospital-based retrospective analysis of 42 children with neuroimaging-confirmed CSVT recorded between December 2009 and January 2023. ASS was defined as a seizure occurring within 7 days after CSVT. Predictors for ASS were analyzed by univariate and multivariate logistic regression. Functional outcomes were evaluated using the Pediatric Stroke Outcome Measure (PSOM).
Results: The average age of the 42 patients included in the study sample was 105.36 ± 63.1 months. Almost one-third (28.6 %) of patients with CSVT developed ASS. In univariate analysis, factors associated with seizure risk were young age, low Glasgow Coma Scale at admission, long hospital stay, headache, change of consciousness, focal neurological findings, cerebral hemorrhage, motor deficit and high D-dimer level (p=0.018, p<0.001, p= 0.016, p= 0.001, p=0.014, p<0.001, p<0.001, p=0.019 and p=0.013, respectively). In multivariate analysis young age, focal neurological findings and D-dimer levels were potential predictors of ASS (p=0.004, p=0.003, p=0.036, respectively). Receiver operating characteristic (ROC) analysis for D-dimer diagnostic accuracy in patients with CSVT revealed D-dimer > 498 ng/mL (AUC=0.743). In both cohorts, PSOM scores at last follow-up were worse in those with acute seizures compared to those without (p<0.001).
Conclusion: Acute seizures occurred in approximately one-third of our cohort. Young age, focal neurological findings, and high D-dimer levels are potential predictors of ASS in children. Children with ASS had worse outcomes than those without.
(Copyright © 2024. Published by Elsevier B.V.)
Databáze: MEDLINE
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