EPILEPSY IN CHILDREN WITH MENINGOMYELOCELE

The medical records of 89 children followed at a multidisciplinary Men ingomyelocele Clinic at the Children's Clinics for Rehabilitative Serv ices were reviewed, Almost all children in southern Arizona with menin gomyelocele are followed at this clinic, Eight children (foreign natio nals) were excluded because they were not eligible for neurosurgery/ne urology services at the clinic, The remaining 81 children have been fo llowed at the clinic from 0.25 to 21 years, Seventeen children (21%; a ge: 1.3-17 years, mean: 9.1 +/- 4.4 years; follow-up: 1.3-16 years) ma nifested seizures at some time during their course, All children with seizures had shunted hydrocephalus. Neonatal seizures occurred in 2 ch ildren currently not receiving medication. An additional 3 children ha d an acute symptomatic seizure associated with an intraventricular)hem orrhage during ventriculoperitoneal shunt revision, 2 of whom later de veloped epilepsy, Fourteen children (17.3%) had epilepsy; 12 were taki ng antiepileptic drugs. Seizures were controlled on medication in 5 ch ildren, EEG abnormalities were present in 12 children (focal slowing 4 , focal spikes 8, diffuse slowing 3, generalized or bilaterally synchr onous spike-wave 4), Most of these children (12/14) had evidence of ad ditional central nervous system (CNS) pathology (i,e,, areas of enceph alomalacia or past stroke 7, cerebral malformations 2, CNS calcificati ons 1, and frequent apneic spells/cardiac arrest 2), We conclude that epilepsy occurs in approximately 17% of children with meningomyelocele , and most have other CNS pathology to account for their seizures.