Epilepsy in Childhood Shunted Hydrocephalus
Object. The incidence of epilepsy among children with hydrocephalus is well recognized. Its relation to shunts and with the transient episodes of raised intracranial pressure related with shunt obstruction can be a complicating factor of the management of shunt malfunction. In this chapter the authors review a series of 802 children with hydrocephalus of different etiologies, treated by ventriculoperitoneal shunt placement between 1980 and 1990, with a mean follow-up period of 8 years. Patients with tumoral hydrocephalus were excluded. Data extracted from medical records were retrospectively analyzed. Thirty-two percent of the children had epilepsy. In most of the cases, the onset was contemporary with the diagnosis of hydrocephalus. Severe uncontrolled epilepsy was present in most of the cases. The incidence of epilepsy was mainly related with the original cause of the hydrocephalus. The presence of radiological abnormalities was a significant predictor of epilepsy. Similarly, shunt complications with related periods of raised intracranial pressure predisposed to epilepsy. The presence of a shunt by itself was found to be able to promote an epileptogenic focus. Epilepsy is an important predictor of poor intellectual outcome in hydrocephalic children with shunts.
KeywordsEpilepsy Seizures Children Hydrocephalus Ventriculoperitoneal shunt malfunction Slit ventricle syndrome CSF shunt obstruction
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