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Sickle cell disease: ischemia and seizures

Sickle cell disease: ischemia and seizures
Sickle cell disease: ischemia and seizures
Although the prevalence of seizures in children with sickle cell disease (SCD) is 10 times that of the general population, there are few prospectively collected data on mechanism. With transcranial Doppler and magnetic resonance imaging (MRI) and angiography, we evaluated 76 patients with sickle cell disease, 29 asymptomatic and 47 with neurological complications (seizures, stroke, transient ischemic attack, learning difficulty, headaches, or abnormal transcranial Doppler), who also underwent bolus-tracking perfusion MRI. The six patients with recent seizures also had electroencephalography. Group comparisons (seizure, nonseizure, and asymptomatic) indicated that abnormal transcranial Doppler was more common in the seizure (4/6; 67%) and nonseizure (26/41; 63%) groups than in the asymptomatic (10/29; 34%) group (2; p = 0.045), but abnormal structural MRI (2; p = 0.7) or magnetic resonance angiography (2; p = 0.2) were not. Relative decreased cerebral perfusion was found in all seizure patients and in 16 of 32 of the remaining patients with successful perfusion MRI (p = 0.03). In the seizure patients, the perfusion abnormalities in five were ipsilateral to electroencephalographic abnormalities; one had normal electroencephalogram results. These findings suggest that vasculopathy and focal hypoperfusion may be factors in the development of sickle cell disease-associated seizures.
0364-5134
290-302
Prengler, Mara
6f2b4ccb-c630-406e-9df2-55147ccc7f5a
Pavlakis, Steven G.
699873a7-5dc0-43b7-8d8a-b83e0253cbf8
Boyd, Stewart
84c9a3f4-62e9-4573-b815-5eb287f1d570
Connelly, Alan
b2e15ed0-c70b-4de6-ab5a-4ff6861859de
Calamante, Fernando
63d493e7-04b6-4147-8353-5f487b994cab
Chong, W.K.
4f1a14d2-d6d8-4a6b-9466-3651b9682b48
Saunders, Dawn
bb545d7c-a34a-42d4-95c8-2395bc274722
Cox, Timothy
63c5c074-f215-4f6b-813a-3fc7b562fc6f
Bynevelt, Michael
b193cce3-8cf6-4b82-ab0a-6bb739b6fa29
Lane, Roderick
ae068a15-fa7b-4d7a-a8a0-f77ede36427a
Laverty, Aidan
f28a739c-6474-4f2b-acca-cc716f8afa41
Kirkham, Fenella J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Prengler, Mara
6f2b4ccb-c630-406e-9df2-55147ccc7f5a
Pavlakis, Steven G.
699873a7-5dc0-43b7-8d8a-b83e0253cbf8
Boyd, Stewart
84c9a3f4-62e9-4573-b815-5eb287f1d570
Connelly, Alan
b2e15ed0-c70b-4de6-ab5a-4ff6861859de
Calamante, Fernando
63d493e7-04b6-4147-8353-5f487b994cab
Chong, W.K.
4f1a14d2-d6d8-4a6b-9466-3651b9682b48
Saunders, Dawn
bb545d7c-a34a-42d4-95c8-2395bc274722
Cox, Timothy
63c5c074-f215-4f6b-813a-3fc7b562fc6f
Bynevelt, Michael
b193cce3-8cf6-4b82-ab0a-6bb739b6fa29
Lane, Roderick
ae068a15-fa7b-4d7a-a8a0-f77ede36427a
Laverty, Aidan
f28a739c-6474-4f2b-acca-cc716f8afa41
Kirkham, Fenella J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58

Prengler, Mara, Pavlakis, Steven G., Boyd, Stewart, Connelly, Alan, Calamante, Fernando, Chong, W.K., Saunders, Dawn, Cox, Timothy, Bynevelt, Michael, Lane, Roderick, Laverty, Aidan and Kirkham, Fenella J. (2005) Sickle cell disease: ischemia and seizures. Annals of Neurology, 58 (2), 290-302. (doi:10.1002/ana.20556).

Record type: Article

Abstract

Although the prevalence of seizures in children with sickle cell disease (SCD) is 10 times that of the general population, there are few prospectively collected data on mechanism. With transcranial Doppler and magnetic resonance imaging (MRI) and angiography, we evaluated 76 patients with sickle cell disease, 29 asymptomatic and 47 with neurological complications (seizures, stroke, transient ischemic attack, learning difficulty, headaches, or abnormal transcranial Doppler), who also underwent bolus-tracking perfusion MRI. The six patients with recent seizures also had electroencephalography. Group comparisons (seizure, nonseizure, and asymptomatic) indicated that abnormal transcranial Doppler was more common in the seizure (4/6; 67%) and nonseizure (26/41; 63%) groups than in the asymptomatic (10/29; 34%) group (2; p = 0.045), but abnormal structural MRI (2; p = 0.7) or magnetic resonance angiography (2; p = 0.2) were not. Relative decreased cerebral perfusion was found in all seizure patients and in 16 of 32 of the remaining patients with successful perfusion MRI (p = 0.03). In the seizure patients, the perfusion abnormalities in five were ipsilateral to electroencephalographic abnormalities; one had normal electroencephalogram results. These findings suggest that vasculopathy and focal hypoperfusion may be factors in the development of sickle cell disease-associated seizures.

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Published date: 2005

Identifiers

Local EPrints ID: 40643
URI: http://eprints.soton.ac.uk/id/eprint/40643
ISSN: 0364-5134
PURE UUID: 794a0d2f-29aa-483a-b69d-92808deb21ac
ORCID for Fenella J. Kirkham: ORCID iD orcid.org/0000-0002-2443-7958

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Date deposited: 07 Jul 2006
Last modified: 16 Mar 2024 03:22

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Contributors

Author: Mara Prengler
Author: Steven G. Pavlakis
Author: Stewart Boyd
Author: Alan Connelly
Author: Fernando Calamante
Author: W.K. Chong
Author: Dawn Saunders
Author: Timothy Cox
Author: Michael Bynevelt
Author: Roderick Lane
Author: Aidan Laverty

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