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

Abstract

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.

Incidence of Epilepsy after Neonatal Seizures: A Population-Based Study

“…Minchom et al [21] reported a 9.8% incidence, but they only considered newborns at term followed up to 3 years. Studies that evaluated the outcome of neonates with seizures detected with video-EEG, have reported a rate of post-neonatal epilepsy similar to that of ours [22][23][24][25][26], higher [27][28][29][30][31] or lower [32], but with differences in selection criteria of patients and length of follow-up. Most studies used clinical criteria only, but this method might overrate the presence of NS, including sudden and purposeless body movements that may be nonconvulsive.…”

“…More recent studies confirmed these data [36] reporting an onset within the first year in 72% of cases. Recurrence of seizures outside the neonatal period was described by Bergman et al [37] in 26.9% of cases (in 50% within 8 months), and by our group [23] in 60% of cases.…”

Epilepsy after neonatal seizures: Literature review

“…4 This co-morbidity is particularly striking when epilepsy is considered as an outcome. 2,5,6 Indeed, it has been reported that 87% of neonates with previous NS who subsequently developed epilepsy, also presented with both mental retardation and cerebral palsy. 2 Whether or not NS have a role in adverse outcomes in the developing brain is still debated, 7 particularly their effect on neurocognitive outcome, regardless of the underlying aetiology.…”

“…2,5,6 Indeed, it has been reported that 87% of neonates with previous NS who subsequently developed epilepsy, also presented with both mental retardation and cerebral palsy. 2 Whether or not NS have a role in adverse outcomes in the developing brain is still debated, 7 particularly their effect on neurocognitive outcome, regardless of the underlying aetiology. 8 Furthermore, the relationship between NS and the development of epilepsy later in life is still unclear.…”

“…Almost three-quarters of the recurrent seizures occur within the first year of life 9 and the remainder usually before the age of five years. 2 Estimates on epilepsy after NS vary widely, ranging from 16% to 56%, depending on selection criteria and length of the follow-up. 3 We present a literature review on the incidence of epilepsy after seizures in the neonatal period and we also analyse the main risk factors for epilepsy.…”