Neurodevelopmental outcome of neonatal seizures: A longitudinal study.
Eur J Paediatr Neurol
; 49: 17-26, 2024 Mar.
Article
em En
| MEDLINE
| ID: mdl-38324990
ABSTRACT
INTRODUCTION:
Neonatal seizures (NS) are the most common neurological emergency in the neonatal period. The International League Against Epilepsy (ILAE) proposed a new classification of NS based on semiology and highlighted the correlation between semiology and aetiology. However, neurodevelopmental outcomes have not been comprehensively evaluated based on this new classification.AIMS:
To evaluate neurodevelopmental outcomes and potential risk factors for severe outcomes in NS.METHODS:
Patients with video electroencephalogram confirmed NS were evaluated. Seizure aetiology, cerebral magnetic resonance imaging (MRI) data, background electroencephalograms data, general movements, and neurodevelopmental outcomes were analysed. Severe outcomes were one of the following death, cerebral palsy, Griffiths developmental quotient <70, epilepsy, deafness, or blindness.RESULTS:
A total of 74 neonates were evaluated 62 (83.8 %) with acute provoked NS (primarily hypoxic-ischaemic encephalopathy), and 12 (16.2 %) with neonatal-onset epilepsies (self-limited neonatal epilepsy, developmental and epileptic encephalopathy, cerebral malformations). Of these, 32 (43.2 %) had electrographic seizures, while 42 (56.7 %) had electroclinical seizures - 38 (90.5 %) were motor (42.1 % clonic) and 4 (9.5 %) were non-motor phenomena. Severe outcomes occurred in 33 of the 74 (44.6 %) participants. In multivariate analysis, neonatal-onset epilepsies (odds ratio [OR] 1.3; 95 % confidence interval [CI] 1.1-1.6), status epilepticus (OR 5.4; 95 % CI 1.5-19.9), and abnormal general movements (OR 3.4; 95 % CI 1.9-7.6) were associated with severe outcomes.CONCLUSIONS:
At present, hypoxic-ischaemic encephalopathy remains the most frequent aetiology of NS. The prognosis of neonatal-onset epilepsies was worse than that of acute provoked NS, and status epilepticus was the most predictive factor for adverse outcomes.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Convulsões
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Imageamento por Ressonância Magnética
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Eletroencefalografia
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Infant
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Male
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Newborn
Idioma:
En
Revista:
Eur J Paediatr Neurol
Ano de publicação:
2024
Tipo de documento:
Article