소아기 뇌졸중 후 발생한 간질에 대한 임상적 관찰
Epilepsy after Stroke in Children
박현주, 정경중, 김근모, 김병주, 우영종, 이정길, 김재휴,
소속 상세정보
박현주 ( Park Hyun-Ju )
전남대학교 의과대학 소아과학교실
정경중 ( Jeong Kyoung-Jung )
전남대학교 의과대학 소아과학교실
김근모 ( Kim Geun-Mo )
전남대학교 의과대학 소아과학교실
김병주 ( Kim Byung-Ju )
전남대학교 의과대학 소아과학교실
우영종 ( Woo Young-Jong )
전남대학교 의과대학 소아과학교실
이정길 ( Lee Jeong-Kil )
전남대학교 의과대학 신경외과학교실
김재휴 ( Kim Jae-Hyu )
전남대학교 의과대학 신경외과학교실
KMID : 0877219980020010003
Abstract
Background: It has been reported that seizures commonly occur in childhood stroke and risk factors for recurrent seizures include later onset of initial seizures and presence of cortical involvement. We studied retrospectively selected groups of children with stroke to determine the incidence, clinical features, and prognosis of the epilepsy associated stroke.
Methods: Detailed records of 58 children (male 30, female 28) with ischemic or hemorrhagic strokes between 1987 and 1996, were reviewed. Those cases which occurred during the neonatal period or those secondary to trauma, malignancy, or bacterial infection were excluded from the study.
Results: Among 58 stroke patients, 46.5% were hemorrhagic, and 53.5% were ischemic. More than 60% of the cases were diagnosed before 5 years of age. Arteriovenous malformation (13), vitamin K deficiency (8) were frequent causes in hemorrhagic strokes, and idiopathic infarction (16), hemiconvulsion-hemiplegia-epilepsy syndrome (7), moyamoya disease (6) were frequent in ischemic strokes. Initial seizures were documented in 44.4% of hemorrhagic strokes and 51.6% of ischei-nic strokes. 55.2% (32 cases) developed epilepsy. Mean interval of 25.8 months (1-102 mo) was taken from the initial seizure to the development of epilepsy, and epilepsy developed within the first year after stroke in 19 cases. Types of observed epileptic seizures were frequently generalized (53.2%), simple partial (21.9%), or complex partial (12.5%). Six of 17 postischemic epilepsies (35.3%) and one of 15 posthemorrhagic epilepsies (6.7%) were intractable.
Conclusions: Initial seizures and epilepsies commonly occur in childhood strokes. Epilepsies are frequently intractable in ischemic strokes.
키워드
소아기 뇌졸중;간질
Stroke in children;Initial seizure;Epilepsy
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