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Journal of Child Neurology
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Pediatric Epilepsy Evaluations From the Prenatal Perspective

Mark S. Scher, MD

Department of Pediatrics, Rainbow Babies and Children's Hospital/MacDonald Hospital for Women, Case Western Reserve University, Cleveland, Ohio, Mark.Scher{at}uhhs.com

Brenda M. Kidder, RN, MSN

Department of Pediatrics, Rainbow Babies and Children's Hospital/MacDonald Hospital for Women, Case Western Reserve University, Cleveland, Ohio

Barbara A. Bangert, MD

Department of Radiology, Rainbow Babies and Children's Hospital/MacDonald Hospital for Women, Case Western Reserve University, Cleveland, Ohio

Prenatal contributions to childhood epilepsy include malformations and acquired injuries, which can occur from conception and throughout gestation. Five case histories from the Pediatric Epilepsy Service are discussed that exemplify maternal, fetal, and placental conditions that contribute to childhood epilepsy. Two full-term neonates presented with neonatal seizures, with or without accompanying encephalopathy. Placental pathology suggested antepartum maternal-placental diseases that caused or contributed to their brain disorders. Two children presented as preterm infants with systemic organ system diseases that also implicated brain injury. One child had a complicated maternal history with both genetic and acquired illnesses. Two children required epilepsy surgery, with improved seizure control despite persistent neurocognitive and neurobehavioral deficits related to diffuse encephalopathies. Dual pathology should include prenatal contributions to childhood epilepsy on both a genetic and acquired basis. Epileptologists should consider an ontogenetic approach to study the epileptic condition from a fetal neurology perspective.

Key Words: epilepsy • placenta • fetus • neonate • dual pathology

Journal of Child Neurology, Vol. 22, No. 4, 396-401 (2007)
DOI: 10.1177/0883073807301918
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M. S. Scher
Neonatal Neurologic Consultations: Integration With Maternal-fetal Medicine and Long-term Outcome
NeoReviews, October 1, 2007; 8(10): e435 - e444.
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