A population-based study of neonatal seizures in Fayette County, Kentucky

Lanska, Mary Jo; Lanska, Douglas J.; Baumann, Robert J.; Kryscio, Richard J.

doi:10.1212/wnl.45.4.724

Cited by 217 publications

(139 citation statements)

References 17 publications

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“…The incidence of clinically diagnosed NSs ranges from 1.5 to 3.5 per 1000 live term born babies. [1][2][3] Because most electrographic seizures in the neonate are subclinical, these figures may underestimate their true incidence. [4][5][6][7] Clinical NSs have been correlated with significant neurological morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Limitations of single-channel EEG on the forehead for neonatal seizure detection

2008

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Objectives: In amplitude-integrated EEG, lead placement across the forehead is convenient, but this location has unknown effects on neonatal seizure (NS) detection sensitivity. This study describes the limits of NS detection by a single forehead EEG channel.Study Design: Records were taken from a digital library of conventional EEGs (CEEGs) with NS, previously characterized at a bicentral channel, C 3 -C 4 . We analyzed electrographic characteristics in a single forehead channel, Fp 3 -Fp 4 .Result: A total of 330 seizures from 125 CEEGs were included. With Fp 3 -Fp 4 , at least one NS was detected in 66% of records vs 90% using C 3 -C 4 (P<0.0001). Of 330 seizures, 46% appeared in Fp 3 -Fp 4 vs 73% in C 3 -C 4 (P<0.0001). Seizures appeared briefer in Fp 3 -Fp 4 than C 3 -C 4 (P<0.006) and CEEG (P<0.0001). Conclusion:NSs are significantly more difficult to detect with a single forehead channel than bicentrally or on CEEG. In Fp 3 -Fp 4 , a third of records with seizures were missed and over half of seizures were undetected.

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Section: Introductionmentioning

confidence: 99%

Limitations of single-channel EEG on the forehead for neonatal seizure detection

2008

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“…First, the incidence of seizures is greater in the neonatal period than at any other time of life, and the vast majority of seizures that occur during this period do so within the first week of life. The reported incidence of seizures has varied between 1.8/1,000 and 5.1/1,000 live births, depending on the methodology used and the locale and dates of specific studies (19)(20)(21)(22). Within the groups studied, the incidence of SE may be very high, depending on definition, Scher and colleagues (4) found that 33% of full-term neonates with seizures could be diagnosed with SE, defined by either the occurrence of a single 30-min seizure, the presence of seizures during at least 50% of an EEG recording, or both.…”

Section: Occurrence Of Neonatal Seizuresmentioning

confidence: 99%

Acute and Chronic Effects of Seizures in the Developing Brain: Lessons from Clinical Experience

Mizrahi

1999

Epilepsia

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Summary: Seizures in the neonate are often considered a form of status epilepticus (SE) because they are relatively prolonged, difficult to control with antiepileptic drugs (AEDs), and may be associated with significant morbidity and mortality. Despite their clinical importance, there is still no clear understanding of how seizures may affect the developing brain. Although both basic neuroscience and clinical research have addressed these issues, there are difficulties in the design and analysis of each type of investigation. Animal studies should reflect the human condition, the most relevant studies being those that consider neocortical rather than hippocampal seizures. Clinical investigations should be based on precise, age-specific definitions of seizures of epileptic origin and of SE. Treatment strategies should be standardized with defined rationale and end points. Outcome measures are best when defined and quantifiable. The relative effects of underlying CNS injuries that coexist with the onset of neonatal seizures may be difficult to differentiate from the effects of the seizures themselves or their treatment. Current clinical studies suggest that the overriding factors in determining the outcome of neonates with seizures are the cause, the degree, and the distribution of brain injury at the time of seizure occurrence. However, such studies have limitations and may not yet employ methodology sensitive enough to detect a full range of adverse effects of seizures themselves.

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“…1 The risk of seizures is highest during the neonatal period, with US population-based studies reporting an incidence of seizures of 1.8 to 5 out of every 1000 live births. [2][3][4] Neonatal seizures are different, in terms of aetiology, semiology, electroencephalographic features, treatment options, and treatment responses, from seizures affecting other age groups. 5 Idiopathic seizures are extremely rare, and most neonatal seizures are symptomatic.…”

mentioning

confidence: 99%

“…5 Idiopathic seizures are extremely rare, and most neonatal seizures are symptomatic. 2,3,5 More than 90% of neonatal seizures are accounted for by hypoxic-ischaemic encephalopathy (HIE), cerebral vascular ischaemia and haemorrhage, cerebral malformation, and infections. Hypoxic-ischaemic encephalopathy is the most common cause of neonatal seizures, with a reported incidence of 1 to 2 per 1000 live births.…”

mentioning

confidence: 99%

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Neonatal seizures in hypoxic–ischaemic encephalopathy – risks and benefits of anticonvulsant therapy

Shetty

2015

Develop Med Child Neuro

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The risk of seizures is at its highest during the neonatal period, and the most common cause of neonatal seizures is hypoxic–ischaemic encephalopathy (HIE). This enhanced vulnerability is caused by an imbalance in the expression of receptors for excitatory and inhibitory neurotransmission, which is age dependent. There has been progress in detecting the electrophysiological abnormalities associated with seizures using amplitude‐integrated electroencephalography (aEEG). Data from animal studies indicate a variety of risk factors for seizures, but there are limited clinical data looking at the long‐term neurodevelopmental consequences of seizures alone. Neonatal seizures are also associated with increased risk of further epileptic seizures; however, it is less clear whether or not this results from an underlying pathology, and whether or not seizures confer additional risk. Phenobarbital and phenytoin are still the first‐line antiepileptic drugs (AEDs) used to treat neonatal seizures, although they are effective in only one‐third of affected infants. Furthermore, based on findings from animal studies, there are concerns regarding the risks associated with using these AEDs. Clinicians face a difficult challenge because, although seizures can be easily identified using aEEG, treatment options are limited, and there are uncertainties regarding treatment outcomes. There is a need to obtain long‐term follow‐up data, comparing groups of infants treated with or without current therapies. If these analyses indicate a definite benefit of treating neonatal seizures, then novel therapeutic approaches should be developed.

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A population-based study of neonatal seizures in Fayette County, Kentucky

Cited by 217 publications

References 17 publications

Limitations of single-channel EEG on the forehead for neonatal seizure detection

Limitations of single-channel EEG on the forehead for neonatal seizure detection

Acute and Chronic Effects of Seizures in the Developing Brain: Lessons from Clinical Experience

Neonatal seizures in hypoxic–ischaemic encephalopathy – risks and benefits of anticonvulsant therapy

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