Associations of Acute Seizure Patterns With Functional Outcomes, Mortality, and Remote Seizures After Pediatric Ischemic Stroke
- 1Department of Neurology, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine University of Science and Technology of China Hefei Anhui China
- 2Department of Pediatrics The 7th Medical Center of Chinese People's Liberation Army General Hospital Beijing China
Abstract
Background: Acute symptomatic seizures are common after pediatric ischemic stroke, but their associations with recovery, mortality, and later remote seizures, and the role of antiseizure medications, remain uncertain, especially in Chinese cohorts.
Methods: We analyzed a prospective multicenter cohort of children aged 29 days to 18 years with ischemic stroke enrolled in the CPISR (Chinese Pediatric Ischemic Stroke Registry) (January 2022–May 2024). Exposures included acute seizures and antiseizure medications. Outcomes included Pediatric Stroke Outcome Measure at 90 days and 1 year, functional improvement, mortality, and poststroke epilepsy.
Results: Among 562 children, 137 had acute seizures, including 30 with status epilepticus and 68 with multiple seizures. In fully adjusted models, status epilepticus was associated with poor 1‐year functional outcome (adjusted odds ratio [OR], 6.29 [95% CI, 2.10–19.09]) and higher odds of no functional improvement (adjusted OR, 2.90 [95% CI, 1.08–9.26]); multiple seizures were also associated with no functional improvement (adjusted OR, 2.33 [95% CI, 1.11–5.17]). In exploratory analyses, acute seizures were associated with worse Pediatric Stroke Outcome Measure subdomain scores at both 90 days and 1 year, whereas no independent association with all‐cause mortality was observed after full adjustment. Acute seizures were associated with an increased risk of poststroke epilepsy (adjusted hazard ratio, 5.52 [95% CI, 2.63–11.58]), particularly in children presenting with status epilepticus or multiple seizures. Prophylactic and early antiseizure medication use were not significantly associated with outcomes.
Conclusions: Acute status epilepticus and multiple seizures were associated with poorer recovery and higher risk of poststroke epilepsy, supporting risk stratification and targeted follow‐up.
Registration: URL: https://www.chictr.org.cn; Unique identifier: ChiCTR2200059915.
Related
- Yield of Low Serum Vitamin B12 Results in General Pediatric Outpatient Practice: Age-Specific Patterns and Associations with Testing Indications and Recorded Clinical Features
- Pectoralis muscle features assessed by chest CT and their associations with clinical and functional outcomes in children and adolescents with cystic fibrosis: a cross-sectional study
- The associations between healthful and unhealthful plant-based dietary patterns and all-cause mortality among older Chinese adults with data-adapted early-stage cardiovascular-kidney-metabolic syndrome (stages 0–2): a prospective cohort study from the CLHLS
- Associations of dietary inflammatory index with incident cardiovascular outcomes and all-cause mortality in patients with prediabetes and type 2 diabetes mellitus: A prospective study of data from the UK Biobank
- Epidemiological patterns, clinical profiles and mortality outcomes of patients with heart failure: a retrospective, hospital-based, single-center study in northern Iran
BibTeX
@article{dong2026associations,
title = {{Associations of Acute Seizure Patterns With Functional Outcomes, Mortality, and Remote Seizures After Pediatric Ischemic Stroke}},
author = {Yiran Dong and Bin Zhu and Wanqiu Zhang and Jinghui Zhong and Xinfeng Liu and Wen Sun},
journal = {Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease},
year = {2026},
month = sep,
doi = {10.1161/jaha.126.049931},
url = {https://doi.org/10.1161/jaha.126.049931},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Associations of Acute Seizure Patterns With Functional Outcomes, Mortality, and Remote Seizures After Pediatric Ischemic Stroke
AU - Yiran Dong
AU - Bin Zhu
AU - Wanqiu Zhang
AU - Jinghui Zhong
AU - Xinfeng Liu
AU - Wen Sun
PY - 2026
DA - 2026/09/09
JO - Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
DO - 10.1161/jaha.126.049931
UR - https://doi.org/10.1161/jaha.126.049931
AB - Background: Acute symptomatic seizures are common after pediatric ischemic stroke, but their associations with recovery, mortality, and later remote seizures, and the role of antiseizure medications, remain uncertain, especially in Chinese cohorts. Methods: We analyzed a prospective multicenter cohort of children aged 29 days to 18 years with ischemic stroke enrolled in the CPISR (Chinese Pediatric Ischemic Stroke Registry) (January 2022–May 2024). Exposures included acute seizures and antiseizure medications. Outcomes included Pediatric Stroke Outcome Measure at 90 days and 1 year, functional improvement, mortality, and poststroke epilepsy. Results: Among 562 children, 137 had acute seizures, including 30 with status epilepticus and 68 with multiple seizures. In fully adjusted models, status epilepticus was associated with poor 1‐year functional outcome (adjusted odds ratio [OR], 6.29 [95% CI, 2.10–19.09]) and higher odds of no functional improvement (adjusted OR, 2.90 [95% CI, 1.08–9.26]); multiple seizures were also associated with no functional improvement (adjusted OR, 2.33 [95% CI, 1.11–5.17]). In exploratory analyses, acute seizures were associated with worse Pediatric Stroke Outcome Measure subdomain scores at both 90 days and 1 year, whereas no independent association with all‐cause mortality was observed after full adjustment. Acute seizures were associated with an increased risk of poststroke epilepsy (adjusted hazard ratio, 5.52 [95% CI, 2.63–11.58]), particularly in children presenting with status epilepticus or multiple seizures. Prophylactic and early antiseizure medication use were not significantly associated with outcomes. Conclusions: Acute status epilepticus and multiple seizures were associated with poorer recovery and higher risk of poststroke epilepsy, supporting risk stratification and targeted follow‐up. Registration: URL: https://www.chictr.org.cn; Unique identifier: ChiCTR2200059915.
SN - 2047-9980
ER -