Predictive Factors for Epilepsy in Pediatric Patients With Sturge-Weber Syndrome

Pediatr Neurol. 2016 Nov:64:52-58. doi: 10.1016/j.pediatrneurol.2016.08.009. Epub 2016 Aug 18.

Abstract

Background: Sturge-Weber syndrome is characterized by a facial port-wine stain associated with either or both a retinal angioma and a cerebral pial angioma. Because a pial angioma may not be evident on the initial imaging studies, individuals at risk for epilepsy are often not identified before their first seizure. The aim of this study is to identify predictive factors predisposing Sturge-Weber patients to epilepsy.

Methods: The medical archives and photography database of our institution were reviewed to identify Sturge-Weber Syndrome patients followed up between 1990 and 2015. Patients without epilepsy were compared with patients with epilepsy based on the location of the port-wine stain, its extent and cerebral imaging.

Results: Twenty-four patients were included in the study. Thirteen did not develop epilepsy. Patients with bilateral port-wine stain were at higher risk of epilepsy (P = 0.03). Unilateral port-wine stain did not increase the risk of epilepsy (P = 0.29) regardless of its extent. The presence of developmental venous anomalies on brain imaging was also associated with a higher risk of epilepsy (P = 0.03).

Conclusions: Bilateral facial port-wine stain and cerebral developmental venous anomalies increase the risk of epilepsy in Sturge-Weber syndrome patients. Because they can be detected at birth, they might guide preventive management and follow-up.

Keywords: GNAQ; Sturge–Weber syndrome; developmental venous anomalies; epilepsy; facial angioma; port-wine stain; predictive factors.

MeSH terms

  • Brain / abnormalities
  • Brain / diagnostic imaging
  • Child, Preschool
  • Epilepsy / complications*
  • Epilepsy / diagnostic imaging
  • Epilepsy / epidemiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Male
  • Port-Wine Stain / complications
  • Port-Wine Stain / diagnostic imaging
  • Port-Wine Stain / epidemiology
  • Prognosis
  • Risk Factors
  • Severity of Illness Index
  • Sturge-Weber Syndrome / complications*
  • Sturge-Weber Syndrome / diagnostic imaging
  • Sturge-Weber Syndrome / epidemiology*