Hemiparesis and Epilepsy Are Associated With Worse Reported Health Status Following Unilateral Stroke in Children

• Published in: Pediatric neurology 2015-04, Vol.52 (4), p.428-434
• Main Authors: Smith, Sabrina E., MD, PhD, Vargas, Gray, MS, Cucchiara, Andrew J., PhD, Zelonis, Sarah J., BA, Beslow, Lauren A., MD, MSCE
• Format: Article
• Language: English
• Subjects: Adolescent; Brain Ischemia - complications; Brain Ischemia - physiopathology; Cerebral Hemorrhage - complications; Cerebral Hemorrhage - physiopathology; Child; Child, Preschool; childhood stroke; Epilepsy - etiology; Epilepsy - physiopathology; Female; Functional Laterality; Health Status; Humans; intracerebral hemorrhage; Male; Neurology; Paresis - etiology; Paresis - physiopathology; Pediatrics; PedsQL; perinatal stroke; Severity of Illness Index; Stroke - complications; Stroke - physiopathology
• ISSN: 0887-8994; 1873-5150
• DOI: 10.1016/j.pediatrneurol.2014.11.016

Abstract Background Perinatal and childhood stroke result in neurological impairment in the majority of survivors, but less is known about patient and parent perception of function following stroke in children. Our aim was to characterize parent-proxy and child-reported health status in children following unilateral arterial ischemic stroke or intraparenchymal hemorrhage. Methods Fifty-nine children 2-18 years (30 girls, 29 boys) with unilateral arterial ischemic stroke or spontaneous intraparenchymal hemorrhage at least 6 months before evaluation were enrolled from a single center. The PedsQL version 4.0 Generic Short Form and PedsQL version 3.0 Cerebral Palsy Module were administered to childhood stroke subjects and parents. Generic PedsQL Inventory scores were compared between children with stroke and published data from healthy children. Reported health status scores for children with varying degrees of hemiparesis were compared. Results Children with stroke had lower reported health status scores on the Generic PedsQL Inventory than healthy children. Children with moderate-severe hemiparesis had worse scores than children without hemiparesis on several measures of the Cerebral Palsy Module as reported by both parents and children. The parents of children with epilepsy reported worse scores on several measures compared with children without epilepsy, and the parent scores were lower on several measures for children with lower intelligence quotients. Agreement between parent and child scores was better on the Cerebral Palsy Module than on the Generic Inventory. Conclusions Children with stroke have worse reported health status than healthy controls. Degree of hemiparesis, epilepsy, and lower intelligence quotient affect reported health status on some measures. Agreement between parent-proxy and child scores ranges from slight to good which suggests that both provide useful information.