Epilepsy and Other Neurological Complications in Pediatric Patients With Hemophilia Complicated With Intracranial Hemorrhage: A Retrospective Case Series

Intracranial hemorrhage (ICH) is one of the most serious complications related to the prognosis of patients with hemophilia. It is also one of the major causes of epilepsy in general. However, there are few studies on epilepsy as a complication in patients with hemophilia. This observational study aimed to reveal the characteristics of hemophilia patients with epilepsy caused by ICH. We retrospectively identified five patients with ICH (9.8%) out of 51 patients with hemophilia based on medical records at the Department of Pediatrics, Hiroshima University Hospital. Four patients (7.8%) had a clinical history of ICH, and one patient (1.9%) had no clinical episodes suggestive of ICH, with imaging findings indicating old hemorrhage. Two patients (3.9%) were observed to have focal epilepsy with tonic-clonic seizures, and both had experienced ICH. Both patients were well-controlled with oral sodium valproate. None of the five patients with ICH had other severe neurological complications, such as paralysis. Epilepsy is a complication that should be recognized in patients with hemophilia, even in the absence of neurological sequelae such as paralysis. Imaging studies are important for patients with hemophilia and epilepsy, even in those without obvious clinical episodes of ICH.