Częstość występowania epilepsji u dzieci ze strukturalnymi wadami serca: przegląd systematyczny i metaanaliza
Prevalence of epilepsy in children with structural heart disease: A systematic review and meta-analysis
W skrócie
[Preprint - wstępne wyniki] Badanie wykazało, że epilepsja występuje u około 3% dzieci ze strukturalnymi wadami serca, co jest wyraźnie częściej niż u dzieci bez takich wad. Naukowcy przeanalizowali 8 badań z ponad 21 tysiącami dzieci z całego świata i stwierdzili, że skomplikowane wady serca, operacje kardiologiczne i powikłania neurologiczne w ich trakcie mogą zwiększać ryzyko epilepsji. Autorzy rekomendują regularną obserwację neurologiczną i specjalistyczne badania rozwojowe dla wszystkich dzieci z wadami serca.
Oryginalny abstract (angielski)
Background Children with structural heart disease (SHD), particularly congenital heart disease (CHD), are increasingly recognised as being at risk of adverse neurological outcomes. Although advances in cardiac surgery and perioperative care have markedly improved survival, epilepsy has emerged as an important long-term complication. Reported prevalence estimates vary considerably across studies, and the overall burden remains uncertain. This systematic review and meta-analysis aimed to estimate the pooled prevalence of epilepsy among children with SHD and explore differences according to geographic region, lesion characteristics, and surgical exposure. Methods This systematic review and meta-analysis was conducted in accordance with PRISMA 2020 and MOOSE guidelines and registered in PROSPERO (CRD420261378572). PubMed/MEDLINE, Scopus, and ProQuest were searched for observational studies published between January 2000 and December 2025. Eligible studies included children aged 0–18 years with SHD or CHD reporting epilepsy prevalence or incidence. Two reviewers independently screened studies, extracted data, and assessed methodological quality using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies. A random-effects meta-analysis was performed to estimate pooled prevalence with 95% confidence intervals (CI). Results Eight cohort studies comprising 21,731 children were included. Studies were conducted across North America, Europe, and Asia and predominantly involved surgically managed CHD populations. The pooled prevalence of epilepsy was 3.0% (95% CI 1.3%–4.8%), substantially higher than estimates reported in the general paediatric population. Heterogeneity was considerable (I² = 98.0%; p Conclusions Children with SHD have a substantially increased burden of epilepsy compared with the general paediatric population. Complex lesions, perioperative neurological injury, and cardiac surgical exposure may contribute to epileptogenesis. Long-term neurological surveillance and multidisciplinary neurodevelopmental follow-up should be integrated into routine care for children with SHD.