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Incidence and predictors of epilepsy in children with congenital heart disease

Part of: Surgery

Published online by Cambridge University Press:  09 August 2021

Carlos Castillo-Pinto Open the ORCID record for Carlos Castillo-Pinto [Opens in a new window] ,
Jessica L. Carpenter ,
Mary T. Donofrio ,
Anqing Zhang ,
Gil Wernovsky ,
Pranava Sinha  and
Dana Harrar
Carlos Castillo-Pinto*
Affiliation:
Department of Neurology, Children’s National Hospital, Washington, DC, USA
Jessica L. Carpenter
Affiliation:
Department of Neurology, Children’s National Hospital, Washington, DC, USA
Mary T. Donofrio
Affiliation:
Division of Pediatric Cardiology, Children’s National Hospital, Washington, DC, USA
Anqing Zhang
Affiliation:
Division of Biostatistics and Study Methodology, Children’s National Hospital, Washington, DC, USA
Gil Wernovsky
Affiliation:
Division of Pediatric Cardiology, Children’s National Hospital, Washington, DC, USA Division of Cardiac Critical Care, Children’s National Hospital, Washington, DC, USA
Pranava Sinha
Affiliation:
Division of Cardiovascular Surgery, Children’s National Hospital, Washington, DC, USA
Dana Harrar
Affiliation:
Department of Neurology, Children’s National Hospital, Washington, DC, USA
*
Author for correspondence: C. Castillo-Pinto, MD, Department of Neurology, Division of Clinical Neurophysiology, Nicklaus Children’s Hospital, 3100 SW 62nd Ave, Miami, FL33155, USA. Tel: +1 7866242891; Fax: +1 3056696531. E-mail: ccastillopinto@gmail.com
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Abstract

Objective:

Children with CHD may be at increased risk for epilepsy. While the incidence of perioperative seizures after surgical repair of CHD has been well-described, the incidence of epilepsy is less well-defined. We aim to determine the incidence and predictors of epilepsy in patients with CHD.

Methods:

Retrospective cohort study of patients with CHD who underwent cardiopulmonary bypass at <2 years of age between January, 2012 and December, 2013 and had at least 2 years of follow-up. Clinical variables were extracted from a cardiac surgery database and hospital records. Seizures were defined as acute if they occurred within 7 days after an inciting event. Epilepsy was defined based on the International League Against Epilepsy criteria.

Results:

Two-hundred and twenty-one patients were identified, 157 of whom were included in our analysis. Five patients (3.2%) developed epilepsy. Acute seizures occurred in 12 (7.7%) patients, only one of whom developed epilepsy. Predictors of epilepsy included an earlier gestational age, a lower birth weight, a greater number of cardiac surgeries, a need for extracorporeal membrane oxygenation or a left ventricular assist device, arterial ischaemic stroke, and a longer hospital length of stay.

Conclusions:

Epilepsy in children with CHD is rare. The mechanism of epileptogenesis in these patients may be the result of a complex interaction of patient-specific factors, some of which may be present even before surgery. Larger long-term follow-up studies are needed to identify risk factors associated with epilepsy in these patients.

Keywords

Congenital heart diseaseacute seizuresepilepsy
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 6 , June 2022 , pp. 918 - 924
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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