A study funded by the National Institute of Health (NIH) recently found that there is an increased risk of seizures and epilepsy in infants and children who suffered an intracerebral (brain) hemorrhage (ICH).
Intracerebral Hemorrhage is a High Risk for Seizures and Epilepsy
The study found that in the first two years following intracerebral hemorrhage, one-third of patients will experience a single remote symptomatic seizure and 13% will develop epilepsy. Twenty-eight percent of study participants who underwent continuous EEG monitoring were found to have subclinical EEG-only seizures (seizures with no outward symptoms).
Acute symptomatic seizures – seizures occurring at presentation of ICH or up to 7 days afterward – were documented in 60% of neonates and 43% of older subjects. The median age of non-neonates with acute symptomatic seizures was 2.2 years, compared with 10.8 years for subjects without such seizures.
Infants and Children with ICH Must be Closely Monitored
These findings have serious implications about the necessity of close monitoring following ICH. Many seizures had no symptoms and were detectable only by EEG. A pediatric neurologist at Yale stated that typically, the decision to place a child on continuous EEG monitoring following ICH was often based upon physician intuition, and monitoring was more likely in those who presented with seizures at the time of their stroke. But this study suggests that EEG monitoring should be routinely performed on infants and children who experienced an ICH.
Elevated Intracranial Pressure (ICP) also a Risk Factor for Seizures and Epilepsy
In examining potential risk factors for symptomatic seizures and epilepsy, the study also found that when elevated intracranial pressure (ICP) is present, immediate intervention is required due to the fact that increased ICP is a risk factor for seizures and epilepsy.
ICH and High ICP Requires Close Monitoring and Prompt Intervention
Seizure activity in infants must be prevented because seizures can kill brain cells and cause permanent brain damage. Even isolated, brief seizures can injure the brain. The longer a seizure lasts, the more damage it causes. EEG monitoring of infants and children with ICH is crucial so that physicians can start to treat the seizures and underlying causes the instant they occur. Additionally, when babies and children have elevated ICP, the medical team must promptly provide treatment in order to prevent seizures and epilepsy.
ICH Often Caused During Labor and Delivery
There are a number of complications that can cause intracerebral hemorrhage during labor and delivery. They include:
- Baby macrosomia (large size)
- Small maternal pelvis or cephalopelvic disproportion
- Abnormal presentation (for example, breech or face presentation)
- Trauma from prolonged labor
- Abnormal changes in blood pressure
- Hypoxic ischemic encephalopathy
Severe head and brain trauma to newborns also can occur from medical intervention during labor and delivery. For example:
- Improper use of delivery instruments such as forceps or vacuum extractors
- Improper delivery technique (e.g., excessive twisting or pulling of the infant’s head)
Medical Negligence and ICH / Elevated ICP
All babies and children at risk for ICH, ICP and seizures require close monitoring and prompt intervention. If a physician fails to closely monitor a baby or child with ICH, it is negligence. Failure to treat ICP also constitutes negligence. If the negligence results in injury to the infant or child, it is medical malpractice.
Reiter and Walsh ABC Law Centers have been helping families with birth injuries for many years. Contact our highly skilled attorneys for a free case review via phone at 888-419-2229, live chat (on the left side of this page) or via contact form.