Long-term prognosis in children with neonatal seizures

Ronen, Gabriel M.; Buckley, David; Penney, Sharon; Streiner, David L.

doi:10.1212/01.wnl.0000279335.85797.2c

Cited by 276 publications

(282 citation statements)

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“…Current estimates indicate a prevalence of neonatal seizures ranging from 0.5% in full-term newborns to 22.2% in preterm newborns (2). Neonatal seizures represent a common neurological sign in the neonatal intensive care unit (NICU) and are associated with increased risk of death as well as of long-term morbidity in survivors, including mental retardation and postneonatal epilepsy (3).…”

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confidence: 99%

“…Perinatal brain damage and/ or neonatal seizures can be risk factors for developing epilepsy in later years (2). A recent study reports that ~16% of patients with neonatal seizures die early, whereas 33% have an adverse outcome (3).…”

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confidence: 99%

“…However, published data on the magnitude of the risk of developing postneonatal epilepsy and predisposing factors present considerable variability mainly due to small sample size of some studies, inclusion of newborns with seizures detected only clinically, and short follow-up duration (3,7,8). We attempted to address this gap by evaluating the frequency of postneonatal epilepsy at 7 y of age in a group of patients who presented video-electroencephalogram (EEG)-confirmed neonatal seizures and evaluated the clinical, EEG, and cerebral ultrasound (US) findings associated with the development of epilepsy.…”

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Neonatal seizures and postneonatal epilepsy: a 7-y follow-up study

et al. 2012

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Background: seizures are one of the most common symptoms of acute neurological disorders in newborns. This study aimed at evaluating predictors of epilepsy in newborns with neonatal seizures. Methods: We recruited consecutively 85 neonates with repeated neonatal video-electroencephalogram (eeG)-confirmed seizures between January 1999 and December 2004. The relationship between clinical, eeG, and ultrasound (Us) data in the neonatal period and the development of postneonatal epilepsy was investigated at 7 y of age. results: Fifteen patients (17.6%) developed postneonatal epilepsy. Partial or no response to anticonvulsant therapy (odds ratio (OR) 16.7, 95% confidence interval (cI): 1.8-155.8, P = 0.01; OR 47, 95% cI: 5.2-418.1, P < 0.01, respectively), severely abnormal cerebral Us scan findings (OR: 5.4; 95% cI: 1.1-27.4; P < 0.04), severely abnormal eeG background activity (OR: 9.5; 95% cI: 1.6-54.2; P = 0.01), and the presence of status epilepticus (OR: 6.1; 95% cI: 1.8-20.3; P < 0.01) were found to be predictors of epilepsy. however, only the response to therapy seemed to be an independent predictor of postneonatal epilepsy. conclusion: Neonatal seizures seem to be related to postneonatal epilepsy. Recurrent and prolonged neonatal seizures may act on an epileptogenic substrate, causing further damage, which is responsible for the subsequent clinical expression of epilepsy.

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Neonatal seizures and postneonatal epilepsy: a 7-y follow-up study

et al. 2012

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“…Only 35% were a live and without disability. Twenty four percent of children died and of the survival, 41% had one of epilepsy, mental retardation, cerebral palsy or learning disability (121) . A scoring system to predict the neurological outcome at the onset of neonatal seizures was tested on 106 newborn with neonatal seizures between 1999 and 2004.…”

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Neonatal Seizures

Al-Zwaini¹

2011

Epilepsy in Children - Clinical and Social Aspects

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“…2,3,5 The onset of seizures in neonates with HIE is usually within 2 days of birth, and neonatal seizures are associated with long-term seizure risk and poor neurological outcomes. 6 …”

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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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Long-term prognosis in children with neonatal seizures

Abstract: Poor prognosis for premature infants with seizures is reflected in high rates of subsequent long-term disability and mortality. The severity and timing of the pathologic process continue to be the major determinants for outcome.

Cited by 276 publications

References 30 publications

Neonatal seizures and postneonatal epilepsy: a 7-y follow-up study

Neonatal seizures and postneonatal epilepsy: a 7-y follow-up study

Neonatal Seizures

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

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