Seizures and stroke

Some children have seizures as one of their initial stroke symptoms. The younger a child is at the time of their stroke, the more likely they are to have seizures. Fortunately, these seizures respond well to medication and most children do not need to go home on seizure medication after discharge from the hospital. Seizures are very scary, however, and many parents ask us if their child will have seizures or epilepsy in the future.

To answer these questions, we recently completed a study of 218 children (ages newborn to 18 years) with stroke who have been followed in CHOP’s Pediatric Stroke Program. Children were followed for a few years after their stroke diagnosis and we found epilepsy rates to be low. They were highest in children who had stroke around the time of birth (about one in five to one in 10 children; 10 percent to 20 percent) and lowest in older children (about one in 15 children; 7 percent).

This means that most children will not have later seizures or epilepsy, but you may wish to discuss with your doctor if there are factors that place your child at higher risk. We have not yet developed a way to prevent epilepsy from happening, but many scientists are working on this problem.

Preventing stroke recurrence

One of our biggest concerns after a child has had a stroke is figuring out why it happened in the first place so that we can prevent it from happening again.

Newborns who experience stroke at birth do not generally have a stroke again, and we always reassure parents of this. Stroke in older infants and children can recur, and we recently completed a research study to figure out how frequently that happens.

We looked at 107 children followed in our Stroke Program and found that the rate of stroke recurrence depended largely on which brain blood vessels were involved. In some cases, when blood vessels branching from the carotid artery were involved, recurrence was very low, with less than one in 20 children (about 5 percent) having another stroke. In others, when blood vessels branching from the vertebral or basilar arteries were involved, recurrence was higher, with up to one in five children (about 20 percent) experiencing another stroke.

Knowing which brain blood vessels were involved in your child’s stroke can help physicians better understand the risk of stroke recurrence in your child and ways to prevent it. Our research is important as it will help us develop treatments (like aspirin and blood thinners) to prevent stroke from happening again.

As always, we are very grateful to the children and families who participate in our Pediatric Stroke Registry! Without you, we wouldn’t have been able to complete the research described above.

We are trying to answer many other questions about stroke in children. If you are interested in hearing more, please call our Research Coordinator (Laura Jastrzab) at 267-426-7332.