Acute symptomatic seizures and epilepsy in pediatric patients with central nervous system inflammatory demyelinating diseases.

BACKGROUND AND

OBJECTIVE

To understand the prevalence and risk factors of acute symptomatic seizures (ASSs) and epilepsy in children with central nervous system inflammatory demyelinating diseases (CIDDs).

METHODS

The cohort of children with CIDDs in pediatric department of Peking University First Hospital between January 2013 and June 2024 were followed up. We evaluated and compared the incidence of ASSs among patients with different CIDDs. The correlation between clinical information and the occurrence of ASS was further analyzed. The incidence of epilepsy was analyzed in patients with disease course longer than 1 year.

RESULTS

Of 204 patients with CIDDs, 97 were female (47.5 %), and the age at onset was 6.75 (IQR: 4.50, 9.73) years, with a total of 598 attacks. Of 204 patients, 75 (36.8 %) experienced ASSs, and the incidence of ASSs were significantly higher in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) (39/94, 41.5 %) and seronegative CIDDs (31/72, 43.1 %). Among 598 attacks, 143 (23.9 %) were accompanied by ASSs. ASSs were more likely to occur in attacks manifested as acute disseminated encephalomyelitis (ADEM) and cerebral cortical encephalitis (CCE) phenotypes. Fever (OR=0.453) and cortical involvement on brain MRI (OR=0.191) were independent risk factors for ASSs. Prevalence of epilepsy was 9.9 % (19/192). Patients with multiple demyelinating attacks were more likely to develop epilepsy.

CONCLUSION

The incidence of ASS in children with CIDDs was 36.8 %, which was more common in children with MOGAD or seronegative CIDDs. ASSs were more likely to occur in attacks presented with ADEM and CCE. Prevalence of epilepsy was 9.9 %.