The risk of convulsions: a longitudinal study of normal babies and infants with neonatal damage in the first 6 years of life

Nalin, A; Frigieri, G.; Cordioli, A.; Colò, M.; Tartoni, Pier Luigi

doi:10.1007/bf00307661

Cited by 5 publications

(3 citation statements)

References 24 publications

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“…A case–control study from Germany[12] showed that elderly mother, previous abortions, eclampsia, low birth weight, asphyxia, and post maturity were associated with epilepsy. An Italian follow-up study[13] recognizes asphyxia and neurological syndromes to be important in developing epilepsy in children. Another incident case–control study from Sweden[14] had shown that maternal hypertension (OR 4.8), Apgar score <6 (OR 3.8), abnormal gestational age (OR 6.7), and caesarean section (OR 18) were associated with childhood epilepsy.…”

Section: Discussionmentioning

confidence: 99%

Risk factors of childhood epilepsy in Kerala

Attumalil

Sundaram

Varghese

et al. 2011

Ann Indian Acad Neurol

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Background:We aimed to identify the risk factors for epilepsy in children.Materials and Methods:This case–control retrospective study was carried out in the pediatric neurology outpatient service of the Trivandrum Medical College. All children (1–12 years) with epilepsy satisfying the selection criteria were included, after obtaining consent from parents. Those with single seizures or febrile seizures were excluded. Controls were children without epilepsy attending the same hospital. Parents were interviewed and clinical data were obtained from medical records. Statistical analysis included chi-square test, odds ratio (OR), and logistic regression.Results:There were 82 cases and 160 controls whose mean age was 6.9 + 3.6 and 5.2 + 3.1, years respectively. On univariate analysis, family history of epilepsy, prolonged labor, cyanosis at birth, delayed cry after birth, admission to newborn intensive care unit, presence of congenital malformations, neurocutaneous markers, incessant cry in the first week, delayed developmental milestones, meningitis, encephalitis, and head trauma were found to be significant. On logistic regression, family history of epilepsy (OR 4.7), newborn distress (OR 8.6), delayed developmental milestones (OR 12.6), and head trauma (OR 5.8) were found to be significant predictors. Infants who had history of newborn distress are likely to manifest epilepsy before 1 year if they are eventually going to have epilepsy (OR 3.4).Conclusion:Modifiable factors such as newborn distress and significant head trauma are significant risk factors for childhood epilepsy. Newborn distress is a risk factor for early-onset (<1 year age) epilepsy.

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Section: Discussionmentioning

confidence: 99%

Risk factors of childhood epilepsy in Kerala

Attumalil

Sundaram

Varghese

et al. 2011

Ann Indian Acad Neurol

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“…Infants suffering from episodes of apnoea and bradycardia in the neonatal period are suggested to have an increased incidence of diplegia and other neurological handicaps (Bacola et al 1966) such as an increased risk for convulsion in infants up to six years (Tudehope et al 1986). Up to two years persistent neonatal apnoea appears to be associated with no higher incidence of significant developmental problems (Nalin et al 1990) and with no additional deleterious effect on average intellectual performance though it may be an important causative factor in functional handicap (Koons et al 1993). Furthermore, apnoea has been documented to have a relationship to school age development (Taylor et al 1998).…”

Section: Discussionmentioning

confidence: 99%

Impact of bradycardia on cerebral oxygenation and cerebral blood volume during apnoea in preterm infants

2003

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Apnoea in prematurity is a common problem in neonatology; and it is the impaired oxygen delivery during apnoea, which can harm the brain. The aim of this study was to evaluate the effect of bradycardia (below 80 beats min(-1)) on 'cerebral haemoglobin oxygenation index' (cHbD) and cerebral blood volume (CBV) during apnoea in stable preterm infants measured by means of near infrared spectroscopy. Twenty-six episodes of mixed and central apnoea with bradycardia (bradycardia group) in 20 preterm infants were compared to 26 episodes of mixed and central apnoea without bradycardia (non-bradycardia group) in 19 preterm infants. cHbD decreased significantly more in the bradycardia group (-11.33 micromol 1(-1) after 30 s) than in the non-bradycardia group (-6.36 micromol 1(-1) after 30 s) (p < 0.05). CBV decreased significantly in the bradycardia group (p < 0.05), whereas CBV did not change significantly in the non-bradycardia group. Peripheral oxygen saturation (SaO2) decreased similarly in both groups. The aggravation of decrease of cHbD and the decrease of CBV during bradycardia in association with apnoea could be explained by decrease in cerebral blood flow, which caused decrease in cerebral oxygen delivery. This decrease of oxygen delivery during bradycardia might worsen long-term neurodevelopmental outcome in preterm infants with apnoea.

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“…Of note, it is well known that newborns without MMC who develop CE in combination with IH are also at increased risk for neurocognitive impairment, compared to those who do not develop IH [15,16] . Furthermore, the occurrence of severe apneic episodes independently of the presence or absence of seizures has been shown to be associated with adverse neurodevelopmental outcome [13] . We speculate that the development of these complications contributed significantly to the observed adverse neurocognitive outcome in our cohort, based on the more favorable fi ndings in fMMC children who developed seizures without such complications.…”

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confidence: 99%

The Relationship of Seizure Activity and Chronic Epilepsy in Early Infancy and Short-Term Neurodevelopmental Outcome Following Fetal Myelomeningocele Closure

et al. 2010

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We explored the relationship between seizure activity (SA) and/or chronic epilepsy (CE) and short-term neurodevelopmental outcomes following fetal myelomeningocele (fMMC) surgery. Retrospective databases and a parental questionnaire focusing on common complications of hindbrain herniation associated with MMC were used to determine the incidence of seizures following fMMC surgery. The Bayley Scales of Infant Development II was used to evaluate the neurocognitive outcomes. The available 3-year outcome data were used for analysis. 54 children underwent fMMC closure at our institution between 1998 and 2003. 48 (89%) families participated. The shunt rate was 50% (n=24). Seizures developed in 8/48 (17%) children, 2 (8%) non-shunted and 6 (25%) shunted (P=0.07). Of those six, 3 developed CE. Neurodevelopmental scores in the average range were found in both non-shunted and 3 shunted fMMC children. The remaining 3 shunted toddlers had CE and significant neurodevelopmental delays. Of those, 2 had severe intracranial hemorrhage and one developed frequent apneic spells in combination with epilepsy. The incidence of seizures in fMMC children was similar to previously reported data of postnatally repaired MMC patients. SA alone without CE was not associated with a worse neurocognitive outcome. The occurrence of severe acquired intracranial injury and CE, however, appeared to be correlated with adverse neurocognitive outcome following fMMC surgery.

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The risk of convulsions: a longitudinal study of normal babies and infants with neonatal damage in the first 6 years of life

Cited by 5 publications

References 24 publications

Risk factors of childhood epilepsy in Kerala

Risk factors of childhood epilepsy in Kerala

Impact of bradycardia on cerebral oxygenation and cerebral blood volume during apnoea in preterm infants

The Relationship of Seizure Activity and Chronic Epilepsy in Early Infancy and Short-Term Neurodevelopmental Outcome Following Fetal Myelomeningocele Closure

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