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Neuropediatrics 2021; 52(06): 469-474
DOI: 10.1055/s-0041-1731805
Original Article

Childhood Stroke: Long-Term Outcomes and Health-Related Quality of Life with a Special Focus on the Development of Epilepsy

C. von Stülpnagel
1   Institute for Transition, Rehabilitation and Palliation, Paracelsus Private Medical University of Salzburg, Salzburg, Austria
2   Comprehensive Epilepsy Program for Children, Division of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Department of Pediatrics, University Hospital Munich, LMU Munich, Munich, Germany
,
Sebastian Kutschker
3   Office for General Medicine, Rott am Inn, Germany
,
Wolfgang Sperl
4   University Hospital for Children and Adolescents, Landeskrankenhaus, Salzburg, Austria
,
Steffen Berweck
1   Institute for Transition, Rehabilitation and Palliation, Paracelsus Private Medical University of Salzburg, Salzburg, Austria
5   Center for Pediatric Neurology, Neurorehabilitation and Epileptology; Schön Clinic, Vogtareuth, Germany
,
Martin Staudt
5   Center for Pediatric Neurology, Neurorehabilitation and Epileptology; Schön Clinic, Vogtareuth, Germany
,
Markus Berndt   #
6   Institute for Medical Education, University Hospital, LMU Munich, Munich, Germany
7   Richard W. Riley College of Education and Leadership, Walden University, Minneapolis, Minnesota, United States
,
G. Kluger   #
1   Institute for Transition, Rehabilitation and Palliation, Paracelsus Private Medical University of Salzburg, Salzburg, Austria
5   Center for Pediatric Neurology, Neurorehabilitation and Epileptology; Schön Clinic, Vogtareuth, Germany
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Abstract

Background Childhood stroke is rare and can predispose to post-stroke epilepsy. The purpose of this study was to evaluate long-term quality of life (QoL) in patients with childhood stroke, focusing on epileptic aspects.

Method This involves a retrospective study of 98 patients with childhood stroke (pre- and neonatal strokes excluded), who had been inpatients between 1986 and 2003 for early rehabilitation. Data were obtained via interviews using a standardized questionnaire: QoL evaluation with KINDL, functional outcome with Barthel Index, and motor handicaps-assessment with modified Rankin Score.

Results Forty-nine of 98 patients (31 males, mean follow-up 16 years, range 8–25 years) were included. Six patients passed away (three of sudden unexpected death in epilepsy). At least one epileptic seizure occurred in 27/49 patients (occurrence: 2 days–13 years.; mean 3.3 years.). Epilepsy manifested in 19/49 patients. No correlation was found between the development of epilepsy and the location or etiology of the stroke. The presence of functional independence was significantly higher in seizure-free patients and in patients without epilepsy. For the external assessment (filled in for the patient by the parent/caregiver), there was no significant difference in QoL in patients with and without epilepsy; however, in the in-person KINDL questionnaire a significantly lower QoL was noted in epilepsy patients compared with patients without epilepsy.

Conclusion One important finding in our study is that in the long-term course 39% of patients developed epilepsy after a childhood stroke. It occurred as late as 13 years after the acute episode and affected the QoL especially in cognitively less handicapped patients.

Keywords

childhood stroke - risk of epilepsy - quality of life - long-term outcome

Disclaimer

Parts of this manuscript were submitted as a dissertation.


Disclosure

Gerhard Kluger received speakers' fees by Desitin, GW pharma, Zogenix, and Eisai.


# Both authors contributed equally.




Publication History

Received: 07 October 2020

Accepted: 14 May 2021

Article published online:
12 July 2021

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