Clinical and subclinical epileptic forms after ventriculo-peritoneal bypass surgery

M.V. Malets, Y.Y. Chomolyak


Background. Hydrocephalus is common condition in children, particularly under one year old. Epileptic attacks occurr in hydrocephalus patients three time more often compared to general population. Majority of hydrocephalus patients requires surgical treatment with cerebrospinal fluid shunt surgery. Clinical and subclinical epileptic forms in children with hydrocephalus are under-investigated and require thorough examination. The purpose of our study was to analyze the incidence of clinical and subclinical forms of epilepsy in hydrocephalus patients after ventriculo-peritoneal bypass surgery. Materials and methods. We have analyzed the data of patients with hydrocephalus admitted to the Regional Children’s Hospital in 2015–2019. The case histories of 80 patients with shunted hydrocephalus were retrospectively collected based on the Transcarpathia Regional Children’s Hospital, the video EEG monitoring was performed to the children with shunted hydrocephalus according to the international system 10–20 at rest within 30 minutes. The children with shunted hydrocephalus experienced interictal epileptiform changes on EEG were performed continuous video EEG monitoring while sleeping. Results. Our data demonstrated clinical forms of epilepsy following ventriculo-peritoneal bypass surgery in 31 patients (39.2 %). The most patients (71 %) experienced the focus of epiletiform activity above the hemisphere with cerebrospinal fluid shunt system that links the development of epileptic seizures with irritant effect of the shunt. Subclinical epileptic forms in children following the ventriculo-peritoneal bypass surgery are significantly more rare compared to the clinical. The follow-up within two years revealed concealed electric status of sleep in 6 patients (7.5 %). Conclusions. The diagnosis of the epilepsy forms mentioned above is possible only using video EEG monitoring while activity and sleeping, and the forms require further accuracy investigation.


cerebrospinal fluid shunt system; hydrocephalus; epilepsy; subclinical epilepsy


Tully H.M., Kukull W.A., Mueller B.A. Clinical and Surgical Factors Associated With Increased Epilepsy Risk in Children With Hydrocephalus. Pediatr. Neurol. 2016 Jun. 59. 18-22. doi: 10.1016/j.pediatrneurol.2016.02.011. Epub 2016 Mar 3.

Sato O., Yamguchi T., Kittaka M., Toyama H. Hydrocephalus and epilepsy. Childs Nerv. Syst. 2001 Jan. 17(1–2). 76-86.

Nishiyama I., Pooh K.H., Nakagawa Y. Clinical and electroencephalographic analysis of epilepsy in children with hydrocephalus. No To Hattatsu. 2006 Sep. 38(5). 353-8.

Piatt J.H. Jr, Carlson C.V. Hydrocephalus and epilepsy: an actuarial analysis. Neurosurgery. 1996 Oct. 39(4). 722-7.

Орлов Ю.А., Маловичко І.А., Марущенко Л.Л. Віддалені результати хірургічного лікування гідроцефалії критичного ступеня у дітей перших років життя. Міжнародний неврологічний журнал. 2011. 8(46).

Галич С.Р., Щурко Д.М., Щурко М.І. Епідеміологія вроджених вад розвитку плода в Одеському регіоні. 2013.

Т. 16. № 2.

Tully H.M., Dobyns W.B. Infantile hydrocephalus: a review of epidemiology, classification and causes. Eur. J. Med. Genet. 2014. 57(8). 359-368. doi: 10.1016/j.ejmg.2014.06.002 (

Munch T.N. et al. Familial aggregation of congenital hydrocephalus in a nationwide cohort. Brain. 2012. 135(Pt. 8). 2409-15 [PubMed] [Google Scholar].

Rekate H.L. The definition and classification of hydrocephalus: a personal recommendation to stimulate debate. Cerebrospinal Fluid Res. 2008. 5. 2 [PMC free article] [PubMed] [Google


Robert S. Fisher, J. Helen Cross et al. ILAE Position Paper 10. Operational classification of seizure types by the International League Against Epilepsy: Position Paper of the ILAE Commission for Classification and Terminology. First published: 08 March 2017.

Charles L. Yeager, John S. Guerrant. Subclinical epileptic seizures — Impairment of Motor Performance and Derivative Difficulties. Calif. Med. 1957 Apr. 86(4). 110-117. PMCID: PMC1511881.

Charles L. Yeager, John S. Guerrant. Subclinical epileptic seizures — Impairment of Motor Performance and Derivative Difficulties. Calif. Med. 1957 Apr. 86(4). 242-247. PMCID: PMC1511881.


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.


© Publishing House Zaslavsky, 1997-2020


   Seo анализ сайта