Articles, Issue 1/2023

Epilepsy in Children with Shunted Hydrocephalus – Presentation of Own Results

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M. Panova, I. Pacheva, I. Ivanov


Abstract

Epilepsy is one of the frequent complications in children with shunted hydrocephalus, determining their quality of life. Purpose of the study: to determine the frequency of epilepsy, the type of epileptic seizures and accompanying EEG changes, the most common risk factors for the occurrence of epilepsy and its comorbidities in patients with shunted hydrocephalus
Material and methods: 70 patients (36 males and 34 femails) aged from 1 year and 3 months up to 21 years 4 months with shunted hydrocephalus of different etiology (post-tumor excluded), treated at the Department of Pediatrics and Medical Genetics at St. George UMHAR for a 10-year period. An EEG study was perfomed, developmental assessment, motor function, quality of life and functional status of the examined patients.
Results: 30 (42.9%) of the patients had epilepsy. The most frequent epileptic seizures were partial with secondary generalization. The most common EEG finding is focal activity contralateral to the inserted catheter. We found a statistically significant relationship between epilepsy and gestational age
(p<0.01; χ2=4.41), birth weight (p<0.01; χ2=9.359), Apgar score at birth (p<0.05; χ2=7.483), shunt revisions (p<0.05; χ2=5.65), mechanical complications of the shunting system (p<0.05; χ2=5.833). The presence of epilepsy is reliably associated with cerebral palsy (p<0.05; χ2=5.647), developmental
delay (p<0.001; χ2=13.188), hyperactivity, (p<0.05; r=0.268), decreased quality of life (QOL) (p<0.01; χ2=9.09) and decreased functional status (p<0.001; r= 0.298). Through multiple regression analysis, we found that the determining factors for epilepsy is acquired hydrocephalus P<0.001 (F=7.51).
Conclusion: Epilepsy is a common complication in shunted patients and it depends on multiple factors related to the complex impact of hydrocephalus and its treatment.
Knowledge of the risk factors for epilepsy allows its prevention and improvement of the quality of life of shunted patients.
Key words: shunted hydrocephalus, epilepsy, quality of life, etiology of hydrocephalus, complications of shunting system

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Addres for correspondence:

Department of Pediatrics and Medical Genetics,
Medical University Plovdiv;
15A, “Vasil Aprilov”, Blvd.
4002, Plovdiv
Bulgaria
e-mail: panova_marg@mail.bg