Clinical characteristics and etiology analysis of acute lymphoblastic leukemia combined with epileptic seizures in 10 children
Objective To investigate the clinical characteristics, causes and prognosis of acute lymphoblastic leukemia (ALL) combined with seizures during treatment in children.Methods Clinical data of 166 children diagnosed with ALL who were consecutively admitted to Xingtai People's Hospital from September 2014 to June 2023 was collected.The incidence, clinical characteristics, imaging findings, causes of seizures, and prognosis of children with seizures during treatment were summarized and analyzed.Results Among the 166 children, 10 (6%) presented with seizure symptoms, including 4 boys and 6 girls.The median age at onset of the first seizure was 7.5 years (2 to 12 years).The median time from the beginning of ALL treatment to seizure onset was 38 days (22 to 423 days), with 60% occurring during the induction and remission therapy.Convulsive seizures were the primary manifestation.Abnormalities were found in cranial MRI of 7 cases and in ambulatory electroencephalography of 6 cases.The causes of seizures were reversible posterior encephalopathy syndrome (50%), electrolyte disorders (10%), central nervous system infection (10%), venous sinus thrombosis (10%), and unknown (20%).After anticonvulsant and other treatments, none of the children had any further seizures.Nine children did not have any neurologic sequelae, and 1 child died of central nervous system infection.Conclusion Seizures are a common neurologic complication during ALL treatment, which occur within 2 months of chemotherapy in most cases and present as tonic seizures.Reversible posterior encephalopathy syndrome is the most common cause.Comprehensive imaging and electroencephalography examinations can help early diagnosis and treatment.
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