SEIZURES ASSOCIATED WITH STROKE IN CHILDHOOD

Seventy-three consecutive children younger than 17 years of age seen f rom 1978 to 1992 with acute hemiplegia from stroke, were retrospective ly reviewed to evaluate the incidence of seizures and the risks of rec urrent seizures after stroke, The population consisted of 56 children with cerebral infarction, 12 with intracranial hemorrhage, and 5 with transient ischemic attack, Children whose strokes occurred in the neon atal period and those secondary to trauma, malignancy, or infection we re excluded, Mean follow-up time was 43.5 months (range: 12-156 months ). At least 1 seizure occurred in 36 patients (49.3%) and recurrent se izures occurred in 21 patients (28.8%), Recurrent seizures developed m ore often among patients who had initial seizures with delayed onset ( P < .05), In 56 patients with cerebral infarction, 16 of 31 patients ( 51.6%) with cortical involvement documented by neuroradiologic studies and 1 of 25 patients (4%) without cortical involvement developed recu rrent seizures (P < .01), In 12 patients with intracranial hemorrhage, 3 of 10 patients with cortical involvement and none of 2 patients wit hout cortical involvement developed recurrent seizures, It is conclude d that seizures commonly occur in childhood stroke, Risk factors for r ecurrent seizures include later onset of initial seizures and presence of cortical involvement.