1887
Volume 2025, Issue 1
  • ISSN: 0253-8253
  • E-ISSN: 2227-0426

Myelomeningocele (MMC) is a severe congenital malformation of the CNS (central nervous system) that often leads to seizures due to factors such as shunt complications and hydrocephalus. This study aims to develop a machine learning model to predict the likelihood of seizures in MMC patients by analyzing various predictors.

This retrospective study involved 103 MMC patients. Factors such as demographics, MMC location, shunt history, and imaging were analyzed using the random forest classifier, the support vector classifier, and logistic regression. Model performance was assessed through bootstrap estimates, cross-validation, classification reports, and area under the curve (AUC).

Of the evaluated patients, 11 experienced seizures. The key influencing factors included gestational age, sacral location, hydrocephalus, shunt history, and corpus callosum dysgenesis. Machine learning (ML) models predicted seizure risk with an accuracy of 86–92% and an AUC ranging from 0.764 to 0.865. Significant predictors were imaging findings, shunt infection history, and gestational age.

ML models effectively predict seizure risk in MMC patients, with certain variables showing strong associations and significant impact.

Loading

جارٍ تحميل قياسات المقالة...

/content/journals/10.5339/qmj.2025.15
٢٠٢٥-٠٣-١٧
٢٠٢٦-٠٣-١١

القياسات

Loading full text...

Full text loading...

/deliver/fulltext/qmj/2025/1/qmj.2025.15.html?itemId=/content/journals/10.5339/qmj.2025.15&mimeType=html&fmt=ahah

References

  1. Sahni M, Alsaleem M, Ohri A. Meningomyelocele. StatPearls. Treasure Island (FL): StatPearls Publishing; 2023.
    [Google الباحث العلمي]
  2. Bakaniene I, Zˇiukiene L, Vasiliauskiene V, Prasauskiene A. Participation of children with Spina bifida: a scoping review using the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) as a reference framework. Medicina (Kaunas). 2018 May30; 54:(3):40. doi: 10.3390/medicina54030040.
    [Google الباحث العلمي]
  3. Copp AJ, Adzick NS, Chitty LS, Fletcher JM, Holmbeck GN, Shaw GM. Spina bifida. Nat Rev Dis Primers. 2015 Apr 30:1:15007. doi: 10.1038/nrdp.2015.7.
    [Google الباحث العلمي]
  4. Hampton LE, Fletcher JM, Cirino PT, Blaser S, Kramer LA, Drake J, et al. Hydrocephalus status in spina bifida: an evaluation of variations in neuropsychological outcomes. J Neurosurg Pediatr. 2011 Sep; 8:(3):289–8. doi: 10.3171/2011.6.PEDS10584.
    [Google الباحث العلمي]
  5. Wetzel JS, Heaner DP, Gabel BC, Tubbs RS, Chern JJ. Clinical evaluation and surveillance imaging of children with myelomeningocele and shunted hydrocephalus: a follow-up study. J Neurosurg Pediatr. 2019 Feb1; 23:(2):153–8. doi: 10.3171/2018.7.PEDS1826.
    [Google الباحث العلمي]
  6. Zabel TA, Jacobson LA, Zachik C, Levey E, Kinsman S, Mahone EM. Parent- and self-ratings of executive functions in adolescents and young adults with spina bifida. Clin Neuropsychol. 2011 Aug; 25:(6):926–41. doi: 10.1080/13854046.2011.586002.
    [Google الباحث العلمي]
  7. Bowman RM, McLone DG, Grant JA, Tomita T, Ito JA. Spina bifida outcome: a 25-year prospective. Pediatr Neurosurg. 2001 Mar; 34:(3):114–20. doi: 10.1159/000056005.
    [Google الباحث العلمي]
  8. Blount JP, Campbell JA, Haines SJ. Complications in ventricular cerebrospinal fluid shunting. Neurosurg Clin N Am [online]. 1993 Oct; 4:(4):633–56. Available from: https://pubmed.ncbi.nlm.nih.gov/8241787/.
    [Google الباحث العلمي]
  9. Maghrabi Y, Baeesa S. Shunts and shunt complications. In: Hydrocephalus. Springer International Publishing; 2017. p. 209–21. doi: 10.1007/978-3-319-61304-8_16.
    [Google الباحث العلمي]
  10. Chadduck W, Adametz J. Incidence of seizures in patients with myelomeningocele: a multifactorial analysis. Surg Neurol. 1988 Oct; 30:(4):281–5. doi: 10.1016/0090-3019(88)90300-x.
    [Google الباحث العلمي]
  11. Is¸ik U. Seizures in children with myelomeningocele. In: The Spina bifida. Milan: Springer; 2008. p. 297–301. doi: 10.1007/978-88-470-0651-5_25.
    [Google الباحث العلمي]
  12. Noetzel MJ, Blake JN. Prognosis for seizure control and remission in children with myelomeningocele. Dev Med Child Neurol. 1991 Sep; 33:(9):803–10. doi: 10.1111/j.1469-8749.1991.tb14964.x.
    [Google الباحث العلمي]
  13. Karakas C, Fidan E, Arya K, Webber T, Cracco JB. Frequency, predictors, and outcome of seizures in patients with myelomeningocele: single-center retrospective cohort study. J Child Neurol. 2022 Jan; 37:(1):80–8. doi: 10.1177/08830738211053132.
    [Google الباحث العلمي]
  14. Collins GS, Reitsma JB, Altman DG, Moons K. Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): the TRIPOD Statement. BMJ. 2015 Jan 7::350:g7594. doi: 10.1136/bmj.g7594.
    [Google الباحث العلمي]
  15. Yoshida F, Morioka T, Hashiguchi K, Kawamura T, Miyagi Y, Nagata S, et al. Epilepsy in patients with spina bifida in the lumbosacral region. Neurosurg Rev. 2006 Oct; 29:(4):327–32. Discussion 332. doi: 10.1007/s10143-006-0035-7.
    [Google الباحث العلمي]
  16. Brown TM, Ris MD, Beebe D, Ammerman RT, Oppenheimer SG, Yeates KO, et al. Factors of biological risk and reserve associated with executive behaviors in children and adolescents with spina bifida myelomeningocele. Child Neuropsychol. 2008 Mar; 14:(2):118–34. doi: 10.1080/09297040601147605.
    [Google الباحث العلمي]
  17. Bourgeois M, Sainte-Rose C, Cinalli G, Maixner W, Malucci C, Zerah M, et al. Epilepsy in children with shunted hydrocephalus. J Neurosurg. 1999 Feb; 90:(2):274–81. doi: 10.3171/jns.1999.90.2.0274.
    [Google الباحث العلمي]
  18. Copeland GP, Foy PM, Shaw M. The incidence of epilepsy after ventricular shunting operations. Surg Neurol. 1982 Apr; 17:(4):279–81. doi: 10.1016/0090-3019(82)90122-7.
    [Google الباحث العلمي]
  19. Dan NG, Wade MJ. The incidence of epilepsy after ventricular shunting procedures. J Neurosurg. 1986 Jul; 65:(1):19–21. doi: 10.3171/jns.1986.65.1.0019.
    [Google الباحث العلمي]
  20. Fernell E, Hagberg B, Hagberg G, Hult G, Wendt L. Epidemiology of infantile hydrocephalus in Sweden: a clinical follow-up study in children born at term. Neuropediatrics. 1988 Aug; 19:(3):135–142. doi: 10.1055/s-2008-1052417.
    [Google الباحث العلمي]
  21. Graebner RW, Celesia GG. EEG findings in hydrocephalus and their relation to shunting procedures. Electroencephalogr Clin Neurophysiol. 1973 Nov; 35:(5):517–21. doi: 10.1016/0013-4694(73)90028-X.
    [Google الباحث العلمي]
  22. Hosking GP. Fits in hydrocephalic children. Arch Dis Child. 1974 Aug; 49:(8):633–5. doi: 10.1136/adc.49.8.633.
    [Google الباحث العلمي]
  23. Johnson DL, Conry J, O'Donnell R. Epileptic seizure as a sign of cerebrospinal fluid shunt malfunction. Pediatr Neurosurg. 1996; 24:(5):223–7; discussion 227–8. doi: 10.1159/000121043.
    [Google الباحث العلمي]
  24. Leggate JRS, Baxter P, Minns RA, Steers AJ, Brown JK, Shaw JF, et al. Role of a separate subcutaneous cerebro-spinal fluid reservoir in the management of hydrocephalus. Br J Neurosurg. 1988; 2:(3):327–37. doi: 10.3109/02688698809001003.
    [Google الباحث العلمي]
  25. Marossero F, Massarotti M, Migliore A. [EEG abnormalities in infantile hydrocephalic subjects after ventriculo-atrial shunts]. Riv Neurol [online]. 1970 Jul-Aug; 40:(4):239–41. Available from: https://pubmed.ncbi.nlm.nih.gov/5503717/.
    [Google الباحث العلمي]
  26. Noetzel MJ, Blake JN. Seizures in children with congenital hydrocephalus: long-term outcome. Neurology. 1992 Jul; 42:(7):1277–81. doi: 10.1212/wnl.42.7.1277.
    [Google الباحث العلمي]
  27. Pampiglione G, Laurence KM. Electroencephalographic and clinico-pathological observations in hydrocephalic children. Arch Dis Child. 1962 Oct; 37:(195):491–9. doi: 10.1136/adc.37.195.491.
    [Google الباحث العلمي]
  28. Saukkonen A, Serlo W, von Wend. L. Epilepsy in hydrocephalic children. Acta Paediatr Scand. 1990 Feb; 79:(2):212–8. doi: 10.1111/j.1651-2227.1990.tb11441.x.
    [Google الباحث العلمي]
  29. Stellman GR, Bannister CM, Hillier V. The incidence of seizure disorder in children with acquired and congenital hydrocephalus. Kinderchir. 1986 Dec: 41: Suppl 1:38–41. doi: 10.1055/s-2008-1043396.
    [Google الباحث العلمي]
  30. Talwar D, Baldwin MA, Horbatt CI. Epilepsy in children with meningomyelocele. Pediatr Neurol. 1995 Jul; 13:(1):29–32. doi: 10.1016/0887-8994(95)00088-w.
    [Google الباحث العلمي]
  31. Varfis G, Berney J, Beaumanoir A. Electro-clinical follow-up of shunted hydrocephalic children. Childs Brain. 1977; 3:(3):129–39. doi: 10.1159/000119661.
    [Google الباحث العلمي]
  32. Venes JL, Dauser RC, Epilepsy followin. ventricular shunt placement. J Neurosurg. 1987 Jan; 66:(1):154–5. doi: 10.3171/jns.1987.66.1.0154.
    [Google الباحث العلمي]
  33. Bartoshesky LEHaller J, Scott RM, Wojick C. Seizures in children with meningomyelocele. Am J Dis Child. 1985 Apr; 139:(4):400–2. doi: 10.1001/archpedi.1985.02140060082035.
    [Google الباحث العلمي]
  34. Finney HL, Arlant PA. Focal seizure disorder secondary to multiple shunt revisions. A case report. Childs Brain. 1977; 3:(1):62–4. doi: 10.1159/000119650.
    [Google الباحث العلمي]
  35. Majewska Z, Szelozyn′ska K. Epileptic fits in children with hydrocephalus. Acta Univ Carol Med Monogr. 1976;(75):92–3.
    [Google الباحث العلمي]
  36. Scher MS. Neonatal seizure classification: a fetal perspective concerning childhood epilepsy. Epilepsy Res. 2006 Aug; 70: Suppl 1:S41–57. doi: 10.1016/j.eplepsyres.2005.11.020.
    [Google الباحث العلمي]
  37. Sheth RD, Hobbs GR, Mullett M. Neonatal seizures. J Perinatol. 1999; 19:(1):40–3. doi: 10.1038/sj.jp.7200107.
    [Google الباحث العلمي]
  38. Okurowska-Zawada B, Sobaniec W, Kułak W, Smigielska-Kuzia J, Paszko-Patej G, Sienkiewicz D, et al. Clinical-electroencephalographic analysis of brain bioelectrical activity in children with myelomeningocele and internal hydrocephalus. Adv Med Sci [online]. 2007; 52:(Suppl 1):200–3. Available from: https://pubmed.ncbi.nlm.nih.gov/18229665/.
    [Google الباحث العلمي]
  39. Stein SC, Schut L. Hydrocephalus in myelomeningocele. Pediatr Neurosurg. 1979; 5:(4):413–9. doi: 10.1159/000119836.
    [Google الباحث العلمي]
  40. Laurence KM. The natural history of spina bifida cystica. Proc R Soc Med [online]. 1960 Dec; 53:(12):1055–56. Available from: https://pubmed.ncbi.nlm.nih.gov/13759508/.
    [Google الباحث العلمي]
  41. Lorber J. Systematic ventriculographic studies in infants born with meningomyelocele and encephalocele: the incidence and development of hydrocephalus. Arch Dis Child. 1961 Aug; 36:(188):381–9. doi: 10.1136/adc.36.188.381.
    [Google الباحث العلمي]
/content/journals/10.5339/qmj.2025.15
Loading
/content/journals/10.5339/qmj.2025.15
Loading

جارٍ تحميل البيانات والوسائط...

  • نوع المستند: Research Article
الموضوعات الرئيسية machine learningMyelomeningoceleseizure and ventriculoperitoneal shunt

الأكثر اقتباسًا لهذا الشهر Most Cited RSS feed

هذه الخانة مطلوبة
يُرجى إدخال عنوان بريد إلكتروني صالح
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error