Predictors of Mortality in Neonates with Seizures; a Prospective Cohort Study

Heljic, Suada; Uzicanin, Sajra; Čatibušić, Feriha; Zubčević, Smail

doi:10.5455/medarh.2016.70.182-185

Cited by 20 publications

(17 citation statements)

References 27 publications

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“…Similar to previous reports, HIE followed by ICH was the most common reason for neonatal seizures. 12,20,21 Although the overall incidence of neonatal seizures was similar to a rate of two to five per 1,000 live births reported in the literature, [5][6][7][8][9] the 30% mortality rate found in the current study is almost double the rate compared with that reported by others. 20,[22][23][24] This may be explained by the characteristics of the study population and the high rate of consanguinity found in the current study compared with other reports.…”

Section: Discussionsupporting

confidence: 85%

“…3,10 Mortality among neonates with seizures may reach 20% in the first year of life, particularly when accompanied with prematurity, low birthweight (LBW), low Apgar score, severe neonatal infection, severe hypoxic-ischemic encephalopathy (HIE), brain malformations, grade 3 or 4 intraventricular hemorrhage (IVH), and intracranial hemorrhage (ICH). 11,12 It is essential to determine etiology to effectively treat the underlying cause and to offer a reasonable prognosis when counseling parents. 3 Our institution is the most prominent health care providing institution in the northeast of Israel.…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors for Mortality among Newborns with Neonatal Seizures

et al. 2020

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Objective The aim of the study is to examine the incidence and risk factors for death among neonates who developed neonatal seizures (NS) in an ethnically distinctive community with high consanguinity rate in Israel. Methods Retrospective study was conducted at a single institution on data between January 2001 and January 2016. All neonates diagnosed with NS developed up to age 28 days were included. Mortality was defined as death within the first year of life. Results Of all 69,460 neonates born during the study period, 118 (1.7 per 1,000 live births) developed NS; 35 (29.7%) died within the first year while 83 (70.3%) survived. The leading causes of death were developmental brain malformation (31.4%), genetic/metabolic (20%), hypoxic ischemic encephalopathy (20%), intracranial hemorrhage (11.4%) and infections (11.4%). Any consanguinity between the parents was found in 18 and 14.6% among the survivors and deceased groups, respectively (p = 0.24). Developmental brain malformations that lead to death were present in 3.6 and 31.4% in the survivors and deceased groups, respectively (p = 0.001; relative risk 8.70; 95% confidence interval 2.58–29.27). Stepwise backward logistic regression analysis revealed that developmental brain malformations (p < 0.0001), use of more than one antiepileptic medication (p = 0.006), and multiorgan failure (p = 0.004) were significant risk factors that predicted death. Conclusion The results of the current study show that developmental brain malformations that cause NS were the leading risk factor for death.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Risk Factors for Mortality among Newborns with Neonatal Seizures

et al. 2020

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“…Global cerebral hypoxiaischemia is the most common etiology of neonatal seizures, followed by intracranial bleed, hypoglycemia, septicemia, hypocalcemia, BE, CNS malformations. 22 Seizure etiology, early onset of seizures, prolonged, repetitive and the need for multiple anticonvulsants to control seizure activity are always associated with an increased mortality.…”

Section: Resultsmentioning

confidence: 99%

Neonatal seizures and outcome in a NICU of a tertiary care hospital of Andhra Pradesh-an two year study

Nagaram

Piduru

Munagala

2017

Int J Contemp Pediatr

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Background: Seizures are the most frequent clinical manifestation of central nervous system dysfunction in the newborn with the incidence varying from 1-5%. Neonatal seizures often signal an underlying ominous neurological condition, most commonly hypoxia-ischemia, and others include stroke, intraventricular hemorrhage or intraparenchymal hemorrhage, meningitis, sepsis, and metabolic disorders. Neonatal seizures can permanently disrupt neuronal development, induce synaptic reorganization, alter plasticity and "prime" the brain to increased damage from seizures later in life. The present study was undertaken to delineate the various aspects of neonatal seizures, with special reference to etiology, clinical spectrum, and outcome in the Neonatal Intensive Care Unit (NICU) of a tertiary care Hospital.Methods: A prospective cross sectional study was conducted in an NICU of a tertiary care hospital with 65 neonates in the study group for a period of 2 years. Gestational age assessment is done by modified Ballard’s scoring system and detailed neurological assessment was done. Antenatal history of mother, demographic data, and clinical history of neonate was noted and evaluated. Laboratory investigations were done and results noted and outcome was recorded.Results: Subtle seizure was the commonest (40%) clinical seizures in our study followed by tonic (21.5%). Tonic seizures were common in preterm and in full term subtle seizures. Babies with myoclonic seizures had 100% mortality. Hypoxic ischemic encephalopathy was the commonest cause (41.5%) of mortality in our study. The worst outcome was with CNS malformation (50%). A total of 10 deaths were recorded (15.4%) with maximum association in cases with history of onset 7 days (100%).Conclusions: Neonatal seizures are common and may be the first manifestation of neurological dysfunction after a variety of insults. Seizures may interfere with cardio-respiratory function and nutrition and may have detrimental effects on cerebral development. Global cerebral hypoxia-ischemia is the most common etiology of neonatal seizures, followed by intracranial bleed, hypoglycemia, septicemia, hypocalcemia, BE, CNS malformations.

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“…Normally, seizures are indicative of an underlying dysfunction in the brain. Early life seizures are widely described as a neurological emergency due to a mortality rate as high as 23% and are well documented to cause later life comorbidities such as postnatal epilepsy and global neurodevelopmental delay [3,15]. A seizure is presented when the physiology of the brain abnormally favours excitatory neurotransmission, i.e., promotion of glutamatergic and disinhibition of γ-aminobutyric acid (GABA)ergic transmission.…”

Section: Neonatal Seizuresmentioning

confidence: 99%

“…Presentation of neonatal seizures is most commonly symptomatic of an underlying aetiology rather than idiopathic. Many risk factors associated with neonatal seizures are related to a metabolic imbalance during pregnancy or immediately postdelivery, including perinatal infection, hypoglycaemia and intracranial haemorrhage [4,15,27]. Moreover, rare cases of an inborn genetic component of neonatal seizures exist, with the majority altering metabolic pathways, including KCNQ2 mutations, infantile hypophosphatasia (mutations in the tissue nonspecific alkaline phosphatase (TNAP)) and propionic acidaemia (deficiency of propionyl-CoA carboxylase) [27].…”

Section: Aetiologies Of Neonatal Seizuresmentioning

confidence: 99%

Neonatal Seizures and Purinergic Signalling

Méndez¹,

Smith

Engel

2020

IJMS

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Neonatal seizures are one of the most common comorbidities of neonatal encephalopathy, with seizures aggravating acute injury and clinical outcomes. Current treatment can control early life seizures; however, a high level of pharmacoresistance remains among infants, with increasing evidence suggesting current anti-seizure medication potentiating brain damage. This emphasises the need to develop safer therapeutic strategies with a different mechanism of action. The purinergic system, characterised by the use of adenosine triphosphate and its metabolites as signalling molecules, consists of the membrane-bound P1 and P2 purinoreceptors and proteins to modulate extracellular purine nucleotides and nucleoside levels. Targeting this system is proving successful at treating many disorders and diseases of the central nervous system, including epilepsy. Mounting evidence demonstrates that drugs targeting the purinergic system provide both convulsive and anticonvulsive effects. With components of the purinergic signalling system being widely expressed during brain development, emerging evidence suggests that purinergic signalling contributes to neonatal seizures. In this review, we first provide an overview on neonatal seizure pathology and purinergic signalling during brain development. We then describe in detail recent evidence demonstrating a role for purinergic signalling during neonatal seizures and discuss possible purine-based avenues for seizure suppression in neonates.

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Predictors of Mortality in Neonates with Seizures; a Prospective Cohort Study

Cited by 20 publications

References 27 publications

Risk Factors for Mortality among Newborns with Neonatal Seizures

Risk Factors for Mortality among Newborns with Neonatal Seizures

Neonatal seizures and outcome in a NICU of a tertiary care hospital of Andhra Pradesh-an two year study

Neonatal Seizures and Purinergic Signalling

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