Child's Nervous System

, Volume 24, Issue 2, pp 169–172 | Cite as

Epilepsy associated with shaken baby syndrome

  • Marie Bourgeois
  • Federico Di Rocco
  • Matthew Garnett
  • Brigitte Charron
  • Nathalie Boddaert
  • Christine Soufflet
  • Thomas Roujeau
  • Michel Zerah
  • Christian Sainte-Rose
  • Perrine Plouin
  • Dominique Renier
Brief Communication

Abstract

Object

The shaken baby syndrome (SBS) is an important cause of developmental delay in infants. Epileptic seizures are a common feature of this syndrome. The aim if this study is to analyse the impact of the early and late seizures disorder.

Materials and methods

We have retrospectively reviewed the clinical and electrophysiological findings in a series of 404 children hospitalised with SBS.

Results

In the acute phase, clinical epileptic seizures of various semiologies were found in 73% of the infants. Only 11% of the children had a normal EEG on admission. A poor outcome was found in 88% of the children in case of persisting EEG anomalies despite anti-epileptic treatment with 48% mortality in these patients. The development of refractory epilepsy was also associated with a poor outcome in this series. In fact 96% of the children with seizure recurrence had behavioural problems.

Conclusions

The early recognition and subsequent management of these seizures is vital to prevent further neurological injury. Delayed or recurrent epileptic seizures may occur with a different semiology to the seizures in the acute phase and are also associated with a poor prognosis.

Keywords

Non-accidental trauma Battered child Prognosis Outcome Sub-dural haematoma Seizures Non accidental injury 

References

  1. 1.
    Barlow KM, Spowart JJ, Minns RA (2000) Early posttraumatic seizures in non-accidental head injury: relation to outcome. Dev Med Child Neurol 42:591–594PubMedCrossRefGoogle Scholar
  2. 2.
    Barlow KM, Thomson E, Johnson D, Minns RA (2005) Late neurologic and cognitive sequelae of inflicted traumatic brain injury in infancy Pediatrics 116:174–185CrossRefGoogle Scholar
  3. 3.
    Becker H, Gupta BK (1999) Recognizing abusive head trauma in children. JAMA 282:1421PubMedCrossRefGoogle Scholar
  4. 4.
    Caffey J (1972) On the theory and practice of shaking infants. Am J Dis Child 124:161–169PubMedGoogle Scholar
  5. 5.
    Carty H (1997) Non-accidental injury: a review of the radiology. Eur Radiol 7:1365–1376PubMedCrossRefGoogle Scholar
  6. 6.
    Chiaretti A, De Benedictis R, Polidori G, Piastra M, Iannelli A, Di Rocco C (2000) Early post-traumatic seizures in children with head injury Childs Nerv Syst. 16:862–866PubMedCrossRefGoogle Scholar
  7. 7.
    Duhaime AC, Christian CW, Rorke LB, Zimmerman RA (1998) Nonaccidental head injury in infants—the “shaken-baby syndrome”. N Engl J Med. 18:1822–1829CrossRefGoogle Scholar
  8. 8.
    Duhaime AC, Gennarelli TA, Thibault LE, Bruce DA, Margulies SS, Wiser R (1987) The shaken baby syndrome. A clinical, pathological and biomechanical study. J Neurosurg 66:409–415PubMedGoogle Scholar
  9. 9.
    Duhem R, Vinchon M, Tonnelle V, Soto-Ares G, Leclerc X (2006) Main temporal aspects of the MRI signal of subdural hematomas and practical contribution to dating head injury Neurochirurgie 52(2–3 Pt 1):93–104PubMedGoogle Scholar
  10. 10.
    Handy TC, Hanzlick R, Shields LB, Reichard R, Goudy S (1999) Hypernatremia and subdural hematoma in the pediatric age group: is there a causal relationship? J Forensic Sci 44(6):1114–1118PubMedGoogle Scholar
  11. 11.
    Hoffmann GF, Naughten ER (1998) Abuse or metabolic disorder? Arch Dis Child. 78(4):399PubMedCrossRefGoogle Scholar
  12. 12.
    Howard MA, Bell BA, Uttley D (1993) The pathophysiology of infant subdural haematomas Br J Neurosurg 7:355–365PubMedCrossRefGoogle Scholar
  13. 13.
    Keenan HT, Runyan DK, Marshall SW, Nocera MA, Merten DF, Sinal SH (2003) A population-based study of inflicted traumatic brain injury in young children. JAMA 290:621–626PubMedCrossRefGoogle Scholar
  14. 14.
    Kempe CH, Silverman FN, Steele BF, Droegemueller W, Silver HK (1962) The battered-child syndrome. JAMA 181:17–24PubMedGoogle Scholar
  15. 15.
    Krugman SD, Zorc JJ, Walker AR (2000) Hyponatremic seizures in infancy: association with retinal hemorrhages and physical child abuse? Pediatr Emerg Care 16(6):432–434PubMedCrossRefGoogle Scholar
  16. 16.
    Pierre-Kahn V, Roche O, Dureau P, Uteza Y, Renier D, Pierre-Kahn A, Dufier JL (2003) Ophthalmologic findings in suspected child abuse victims with subdural hematomas. Ophthalmology 110(9):1718–1723PubMedCrossRefGoogle Scholar
  17. 17.
    Tardieu A (1860) A medico-legal study of the sevices and ill treatments conducted on children. Ann Hyg Publique Med Leg 13:361–398Google Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Marie Bourgeois
    • 1
  • Federico Di Rocco
    • 1
  • Matthew Garnett
    • 1
  • Brigitte Charron
    • 2
  • Nathalie Boddaert
    • 3
  • Christine Soufflet
    • 4
  • Thomas Roujeau
    • 1
  • Michel Zerah
    • 1
  • Christian Sainte-Rose
    • 1
  • Perrine Plouin
    • 4
  • Dominique Renier
    • 1
  1. 1.Department of Pediatric NeurosurgeryHôpital Necker Enfants MaladesParisFrance
  2. 2.Department of NeuroanesthesiologyHôpital Necker-Enfants Malades, Paris, Université René DescartesParis VFrance
  3. 3.Department of NeuroradiologyHôpital Necker-Enfants Malades, Paris, Université René DescartesParis VFrance
  4. 4.Clinical Neurophysiology UnitHôpital Necker-Enfants Malades, Paris, Université René DescartesParis VFrance

Personalised recommendations