Abstracts

Rationale: To correlate the epileptic crisis as a clinical manifestation of an ischemic stroke in the pediatric patient. Methods: Retrospective, observational study carried out in the University Hospital “Dr. José E. González” from February 2014 to February 2019. Patients from 0 to 16 years with a diagnosis of Ischemic Stroke confirmed by neuroimaging were recruited. A detailed and structured clinical history was performed to recruit the clinical manifestations, including a first-time seizure. Results: We included 12 patients, 6 (50%) were male and 6 (50%) female. All the included patients had a specific etiology related to the Ischemic Stroke(100%). Mean age was 7 (3 months – 14 years). None of the patients had a previous history of seizures or epilepsy. Half of the patients presented an epileptic crisis: 4 (33%) as the first clinical manifestation and in 2 (16%) as structural epilepsy. 5 (42%) presented focal motor crisis and 1 (8%) bilateral motor crisis. When analyzing the vascular territories, in 4 (33%) the left middle cerebral artery (MCA) was affected and in 4 (33%) included more than one territory, including: right MCA/right anterior cerebral artery (ACA), right MCA/right posterior cerebral artery (PCA) and left MCA/left ACA. In the remaining the affected arteries we the 1 (8%) right MCA, 1 (8%) right ACA, 1 (8%) left PCA and 1 (8%) sagittal sinus.  A total of 4 (33%) patients died, from these, 3(75%) had an epileptic crisis as the first clinical manifestation. Conclusions: Ischemic stroke is a common cause of structural epilepsy (1, 2). Epilepsy after stroke is related to higher mortality (3-5) with limited information from pediatric patients. In our study we report an association between epileptic crisis as a common clinical manifestation (50%) of ischemic stroke in pediatric patients, thus showing a significant correlation with the vascular territory, mainly the Left MCA. We found an important relationship between the ischemic Stroke and epileptic crisis as a prognosis of mortality. We reported 4 deaths and 3 of them presented epileptic crisis as clinical manifestation (75% mortality rate) in this age group.

 Epileptic crisis could be considered as a clinical prognostic of mortality in pediatric patients with ischemic stroke.

 Funding: No funding