Epilepsy Associated with Encephalomalacia in Children

Lyu, Soo Young; Bea, Mi Hye; Lee, Yun Jin; Kim, Young Mi; Nam, Sang Ook

Abstract

PURPOSE
Encephalomalacia is one of the major causes of symptomatic epilepsy. However, no previous study has examined the correlation between encephalomalacia and epilepsy in children. In this study, we aimed to quantify the prevalence, clinical features, and risk factors of epilepsy associated with encephalomalacia.
METHODS
We performed a retrospective review of the medical records of 95 patients who were diagnosed with encephalomalacia by neuroimaging techniques at Pusan National University Children's Hospital between November 2008 and July 2013. Patients were classified into two groups: epilepsy (Group A) and non-epilepsy (Group B). We compared the demographics, underlying causes, and distribution of encephalomalacic lesions of these two groups.
RESULTS
Groups A and B comprised 35 (36.8%) and 60 (63.1%) patients, respectively. Compared to Group B, Group A showed shorter mean gestational period (35.99+/-4.63 vs. 38.09+/-3.70, P=0.02), lower birth weight (2.60+/-0.94 vs. 3.02+/-0.64, P=0.02), and earlier onset of encephalomalacia (2.74+/-3.52 vs. 5.60+/-5.96, P=0.01). In comparing the underlying cause of encephalomalacia, the occurrence of epilepsy was lower after cerebrovascular disease (P<0.01), but trended towards a higher incidence after a central nervous system infection (P=0.09). Multifocal encephalomalacic lesions were significantly higher in Group A (P=0.04).
CONCLUSION
The risk factors for epilepsy associated with encephalomalacia are early gestational age, low birth weight, early onset of encephalomalacia, and multifocal encephalomalacic lesions. It may be necessary for clinicians to search for these risk factors, and make a particularly close observation on these patients.