The incidence of epilepsy in children with hydrocephalus is approximately 30%. Myelomeningocele carries a low risk at approximately 7%, cerebral malformations.

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Presentation transcript:

The incidence of epilepsy in children with hydrocephalus is approximately 30%. Myelomeningocele carries a low risk at approximately 7%, cerebral malformations and intraventricular hemorrhage a moderate risk of approximately 30%, and infection a high risk of approximately 50%. There is a higher incidence of epilepsy among children who had shunt malfunctions, infection, or a combination of both.10 Mental retardation or CNS malformations are poor predictors of seizure control.84 Focal epileptiform discharges and slow waves found in the area of the ventricular catheter may indicate that shunt insertion is responsible for a cortical injury.85,86 Focal abnormalities were found in all children and in 95% of cases they were on the same side as the shunt; in 65% of cases they had amplitude of 300 mV or more. During sleep there was activation of abnormalities in all subjects, and in 33% we found continuous spikes and waves during slow sleep (CSWS).87 CSWS may partly be responsible for neuropsychological disturbances in these patients. Although ventriculoextracranial shunts have been the standard treatment for hydrocephalus, the long-term morbidity, especially postshunt epilepsy and cognitive dysfunction, has to be taken seriously.88 However, the relation of epilepsy to the shunting procedure remains to be a controversial topic.89 Source: Focal Nonepileptoform Activity, Atlas of Pediatric EEG Citation: Laoprasert P. Atlas of Pediatric EEG; 2011 Available at: http://neurology.mhmedical.com/DownloadImage.aspx?image=/data/books/1042/lao001_fig_04-72.gif&sec=59079366&BookID=1042&ChapterSecID=59078726&imagename= Accessed: November 03, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved