Neonatal Status Epilepticus I: Clinical Aspects

Mora, Enrique Udaeta; Alba, G Olmos-García de; Garcia, Dina Villanueva; Valdez, Jorge Malagón

doi:10.1177/155005948401500402

Cited by 8 publications

(4 citation statements)

References 6 publications

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“…The etiologies are almost always an acute CNS insult, an underlying CNS malformation, or a progressive genetic-metabolic disorder. Prognosis is therefore usually poor with high mortality and morbidity (Dreyfus-Brisac and Monod, 1964;Mora et al, 1984;Clancy et al, 1988). With the exception of Aicardi and Chevrie (1970), all studies have excluded neonates under 1 month of age.…”

Section: Classificationmentioning

confidence: 99%

Convulsive Status Epilepticus in Children

Gross‐Tsur

Shinnar

1993

Epilepsia

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Status epilepticus (SE) occurs most commonly in infancy and childhood. Children with prior neurological abnormalities are most susceptible. More than 90% of cases are convulsive and the majority are generalized. SE may occur in the setting of an acute illness, in patients with established epilepsy or as a first unprovoked seizure. The etiology can be classified as idiopathic, remote symptomatic, febrile, acute symptomatic, or associated with a progressive encephalopathy. The morbidity and mortality of status have dramatically declined in recent years. Overall mortality in recent pediatric series was 3-10%, with almost all fatalities associated with acute central nervous system insults or progressive neurologic disorders. Neurological sequelae in children with idiopathic or febrile status are rare. Neurologically normal children with SE as their first unprovoked seizure have the same risk of experiencing subsequent seizures of any type as children who present with a brief first seizure. The risk of recurrent episodes of convulsive SE approaches 50% in neurologically abnormal children but is very low in neurologically normal children. The favorable outcome of SE in children may be related to advances in therapy and to the resistance of the immature brain to damage from seizures.

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Section: Classificationmentioning

confidence: 99%

Convulsive Status Epilepticus in Children

Gross‐Tsur

Shinnar

1993

Epilepsia

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“…The first is an initially severe neurological status. Newborns with an immediately worrying neurological status should therefore be monitored for at least 24 h, since most episodes of SE occur in the first 24 h of life and rarely after 72 h (13,14,15,16).…”

Section: Discussionmentioning

confidence: 99%

“…According to the literature, 8 to 43% of these seizures may evolve to status epilepticus (SE) (1,2,3). Although neonatal convulsions have been widely studied (4,5,6,7,8,9,10,11), the data on neonatal SE are scarce (12,13,14,15,16 ).…”

Section: Introductionmentioning

confidence: 99%

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Predictive factors and prognostic value for status epilepticus in newborns

Gokce-Samar

Ostrowsky‐Coste

Gauthier-Morel

et al. 2019

European Journal of Paediatric Neurology

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Defining neonatal status epilepticus: A scoping review from the ILAE neonatal task force

Nunes,

Yozawitz,

Wusthoff

et al. 2024

Epilepsia Open

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ObjectiveTo review the available literature concerning the definition of neonatal status epilepticus (SE) and/or seizure burden.MethodsThe International League Against Epilepsy Neonatal Task Force performed a scoping review of the definitions of neonatal SE. Following a systematic literature review, articles were screened and data were abstracted regarding: (1) article characteristics (author identification, publication year, journal name, digital object identifier, title, objective, and study design); (2) cohort characteristics (sample size, gestational age, seizure etiology); (3) definition of SE and/or seizure burden; and (4) the method used to identify and classify SE, including routine EEG (EEG), continuous EEG monitoring (cEEG), amplitude‐integrated EEG (aEEG), or clinical features.ResultsThe scoping review yielded 44 articles containing a definition of neonatal SE. Studies mainly included infants with hypoxic–ischemic encephalopathy or neonates considered at risk for seizures. SE identification and classification most often relied on cEEG. The majority of studies based the definition of SE on seizure duration, including summed duration of seizures comprising ≥50% of any 1‐h epoch, recurrent seizures for >50% of the total recording time, or either electrographic seizures lasting >30 min and/or repeated electrographic seizures totaling >50% in any 1‐h period. Seizure burden was reported in 20 studies, and the most commonly used approach assessed total seizure burden, defined as total duration of EEG seizures in minutes. Sixteen studies assessed the relationship between seizure burden and outcomes, and most identified a significant association between higher seizure burden and unfavorable outcomes.SignificanceThis scoping review demonstrates a substantial variation in neonatal SE definitions across the literature. The most common definitions were based around a 30‐min seizure duration criterion, but evidence was insufficient to support that 30 min was a cutoff defining prolonged seizures or that seizures exceeding this burden were more likely to be pharmacoresistant or associated with worse outcomes. As a next step, the Neonatal Task Force intends to develop a standardized approach to assessing and describing neonatal seizure burden and defining neonatal SE.Plain Language SummaryProlonged seizures are a neurologic emergency, if untreated, can lead to permanent injury or death. In adults and children, seizures lasting longer than 30 min are believed to cause brain damage. However, it is not clear if this definition can be applied to neonates. The International League Against Epilepsy Neonatal Taskforce performed a scoping literature review which identified 44 articles containing a definition of neonatal status epilepticus. In this article, the authors reviewed the current used definitions for prolonged seizures in neonates to establish a relationship between seizure duration and neurological outcome. As a next step, the Neonatal Task Force intends to develop a standardized approach to assessing and describing neonatal seizure burden and defining neonatal SE.

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Neonatal Status Epilepticus I: Clinical Aspects

Cited by 8 publications

References 6 publications

Convulsive Status Epilepticus in Children

Convulsive Status Epilepticus in Children

Predictive factors and prognostic value for status epilepticus in newborns

Defining neonatal status epilepticus: A scoping review from the ILAE neonatal task force

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