{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:23:02Z","timestamp":1761823382065},"reference-count":35,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2011,6]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Surgery is increasingly used to treat children with refractory epilepsy. Before surgery, the authors routinely evaluated the coagulation profile to identify coagulation abnormalities not established by personal and family history, physical examination, and routine screening tests.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Thirty-nine consecutive children undergoing testing prior to epilepsy surgery were prospectively evaluated. The authors evaluated a detailed hematological history and an elaborative hematological panel including complete blood count, hepatic panel, anticoagulant levels, coagulation profile (prothrombin time, partial thromboplastin time, international normalized ratio, fibrinogen, thrombin time, von Willebrand antigen, ristocetin cofactor, factor VIII, and individual factor assays when indicated) and platelet aggregation studies (in the presence of adenosine diphosphate, epinephrine, collagen, and ristocetin). Patient variables included tuberous sclerosis complex (TSC), age at epilepsy onset, age at surgery, seizure frequency, number and type of antiepileptic drugs, recent or present ketogenic diet, and use of selective serotonin reuptake inhibitors.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Ten children (25.6%) had either coagulation or platelet function abnormalities. Abnormal coagulation was identified in 5 children, and abnormal platelet function was discovered in 6. A diagnosis of TSC was associated with a platelet function abnormality (p = 0.012), whereas children without TSC had a higher rate of coagulopathy (p = 0.041). None of the other characteristics reached statistical significance. In 2 patients (5.1%) with TSC and platelet aggregation abnormalities, the authors noted normal standard screening laboratory studies and an uneventful detailed personal and family history. One of these 2 patients developed a significant intraoperative bleeding complication.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>A preoperative screening with standard laboratory studies and detailed history may not be adequate to fully examine underlying coagulation abnormalities in children with refractory epilepsy. Platelet aggregation studies should be considered in patients with TSC.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2011.3.peds10559","type":"journal-article","created":{"date-parts":[[2011,6,1]],"date-time":"2011-06-01T14:14:43Z","timestamp":1306937683000},"page":"654-659","source":"Crossref","is-referenced-by-count":9,"title":["Coagulation abnormalities in children undergoing epilepsy surgery"],"prefix":"10.3171","volume":"7","author":[{"given":"Donato","family":"Pacione","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Division of Pediatric Neurosurgery,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francine","family":"Blei","sequence":"additional","affiliation":[{"name":"Vascular Birthmark Institute of Roosevelt, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orrin","family":"Devinsky","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurosurgery, and Psychiatry, Comprehensive Epilepsy Center, NYU Langone Medical Center;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Howard L.","family":"Weiner","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Division of Pediatric Neurosurgery,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Roth","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Division of Pediatric Neurosurgery,"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-0070654","series-title":"Neurochem Res","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1007\/s11064-006-9045-7","article-title":"Successful treatment of epilepsy with serotonin reuptake inhibitors: proposed mechanism","volume":"31","author":"Albano","year":"2006"},{"key":"b2-0070654","series-title":"Epilepsia","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1111\/j.1528-1157.1993.tb00442.x","article-title":"Surgical treatment for epilepsy in cerebral tuberous sclerosis","volume":"34","author":"Bebin","year":"1993"},{"key":"b3-0070654","series-title":"Ann Neurol","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1002\/1531-8249(200101)49:1<98::AID-ANA13>3.0.CO;2-2","article-title":"Bruising and the ketogenic diet: evidence for diet-induced changes in platelet function","volume":"49","author":"Berry-Kravis","year":"2001"},{"key":"b4-0070654","series-title":"Hamostaseologie","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1055\/s-0037-1616942","article-title":"Haemostatic testing prior to elective surgery in children? 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