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

Abstract

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.

© 2025 Al Rifai, Jarrar, Barbarawi, Jamous, Daoud, Jaradat, et al., licensee HBKU Press.
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2025-03-17
2025-04-02
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References

  1. Sahni M, Alsaleem M, Ohri A. Meningomyelocele. StatPearls. Treasure Island (FL): StatPearls Publishing; 2023.
    [Google Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  22. Hosking GP. Fits in hydrocephalic children. Arch Dis Child. 1974 Aug; 49:(8):633–5. doi: 10.1136/adc.49.8.633.
     [Google Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  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 Scholar]
  35. Majewska Z, Szelozyn′ska K. Epileptic fits in children with hydrocephalus. Acta Univ Carol Med Monogr. 1976;(75):92–3.
     [Google Scholar]
  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 Scholar]
  37. Sheth RD, Hobbs GR, Mullett M. Neonatal seizures. J Perinatol. 1999; 19:(1):40–3. doi: 10.1038/sj.jp.7200107.
     [Google Scholar]
  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 Scholar]
  39. Stein SC, Schut L. Hydrocephalus in myelomeningocele. Pediatr Neurosurg. 1979; 5:(4):413–9. doi: 10.1159/000119836.
     [Google Scholar]
  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 Scholar]
  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 Scholar]
/content/journals/10.5339/qmj.2025.15
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Machine learning-based assessment of seizure risk predictors in myelomeningocele patients: A single-center retrospective cohort study
Qatar Medical Journal 2025, 15 (2025); https://doi.org/10.5339/qmj.2025.15
/content/journals/10.5339/qmj.2025.15
/content/journals/10.5339/qmj.2025.15
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  • Article Type: Research Article
Keyword(s): machine learning, Myelomeningocele, seizure and ventriculoperitoneal shunt

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