Abstracts

RATIONALE: Acute seizures (AS) are frequent symptoms of acute neurological or systemic diseases. Brain vascular disease (BVD) is cited as one of the main etiologies of these seizures and, even thought they are more prominent in patients with intracerebral hemorrage, they also are present in patients suffering from thrombotic or embolic BVD. Stroke is a precipitant of status epilepticus in 3.3% of children and 25.2% in adults. The aims are: to know the frequency of AS in the onset of ischemic BVD in children and to identify their main clinical and neuro-physiological characteristics. METHODS: A 30-year retrospective-descriptive study was carried out at the Institute of Neurology and Neurosurgery of Cuba. All the clinical charts of children below 15 years old with discharge diagnosis of ischemic BVD confirmed by CT scan and/or cerebral angiongraphy were reviewed. Demographic, clinical and EEG data were obtained from those who had AS at the onset and compared (x2) with the group of children without AS. Frequency analysis and correlation were established between the variables. (Significance: P<=0.05) RESULTS: Ischemic BVD was diagnosed in 74 children. 19 of them (25.6%) had AS at the onset. Their ages were between 3 months and 13 years (mean=4.90years) and a predominance of males over females(63.2%/36.8%) was found without significant difference when compared with the group of patients without AS (51.4%/48.6%). The seizures were partial in 89.5% and secondary generalization was seen in 21.05%. Status epilepticus was the initial feature in 3 patients (15.78%). AS were more frequent in children younger than 1 year (3 patients) without statistical significance when compared with the group without AS (1 patient). AS were significantly more frequent in patients who suffered from ischemic BVD involving the venous system (4 patients) than the arterial system (15 patients) when compared with the group without AS (P=0.03). CONCLUSIONS: AS were present in one quarter of children with ischemic BVD and suggested ischemia in the venous system. Congenital heart diseases and CNS infections were the major precipitant of AS in children and hemispheric slowing was the major EEG abnormality.