Hydrocephalus is a severe disease in children of all age groups. Failure to treat hydrocephalus in a timely manner can lead to progressive neurological deficits and death. Instead, early diagnosis and treatment of progressive hydrocephalus can completely recover the child. [1]. The term «early diagnosis» of hydrocephalus is the most difficult task for a pediatric neurologist. There are no pathognomonic clinical signs of this disease [1–4]. Detection of electrophysiological signs of hydrocephalus progression in the early stages of the disease could significantly affect on treatment outcomes. The aim of our work is to establish early electrophysiological predictors of the progression of hydrocephalus in children with epilepsy. Materials and methods. 28 children with epilepsy were examined at the Transcarpathian Regional Children’s Hospital and the Medical Center «Diamed» in Uzhhorod from 2018 to 2022. All children were examined prospectively using video-EEG monitoring with sleep fixation, magnetic resonance imaging (MRI), multispiral computer tomography (MSCT). Results. The electrical status epilepticus during slow-wave sleep (ESES) was registered in 35 % of examined patients (8 children). The average duration from detection of the electrical status of sleep to the establishment of shunt system in the brain is 37 days (from 15 to 60 days). The ESES disappeared in 6 children during the first month after the implantation of the shunt system in the brain, in 2 children during the next 3 and 6 months of observation. We have developed our own algorithm for examining children with hydrocephalus and epilepsy up to 1 year and older than 1 year. Conclusion. An intense increase of epileptiform activity and appearance of electrical status of slow-wave sleep may be one of the predictors of the progression and decompensation of hydrocephalus and requires dynamic control. Further randomized trials are needed to assess the significance of these changes. The developed algorithm will increase the effectiveness of the use of additional examination methods for early detection of the progression of hydrocephalus in children with epilepsy.

Received: 18.12.23

Ключові слова: hydrocephalus, epilepsy, electrical sleep status, neuroimaging, shunt system

Повний текст: PDF (Ukr)

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