Predictors of Seizure Development in Septo-optic Dysplasia: A Retrospective Study

ObjectiveTo elucidate factors associated with epilepsy in children with septo-optic dysplasia (SOD).MethodPatients (<21 years) diagnosed with SOD (2013-2023) were identified. Multivariate binomial regression predicted seizures in patients with SOD.ResultsWe identified 107 children (M:F = 46:61) with SOD. Among those, 103 had seizure data. Fifty-two (52/103; 50.5%) experienced seizures. Median age of seizure onset was 9 months (IQR: 4 months -2 years 5 months). Abnormal neurologic examinations were seen in 82.6% with seizures (<i>P</i> = .002). Global developmental delay was noted in 46 (43.0%) and associated with seizures (<i>P</i> = .004). Of 24 patients with autism spectrum disorder, 75% had seizures (<i>P</i> = .01). Ventriculomegaly and schizencephaly were associated with seizures (<i>P</i> = .015, <i>P</i> = .004). No significant associations were found between seizures and SOD diagnostic criteria combinations.InterpretationSeizures are highly prevalent in SOD patients. Diagnostic criteria for SOD do not predict seizures, underscoring the need for comprehensive screening in all SOD patients, irrespective of phenotype.