Agnese Suppiej1, Massimo Mastrangelo2, Laura Mastella3, Patrizia Accorsi4, Luisa Grazian5, Gianluca Casara6, Cinzia Peruzzi7, Maria Luisa Carpanelli8, Augusta Janes9, Annalisa Traverso10, Bernardo Dalla Bernardina11. 1. Child Neurology and Clinical Neurophysiology, Pediatric University Hospital, Padua, Italy. Electronic address: suppiej@pediatria.unipd.it. 2. Pediatric Neurology Unit, V. Buzzi Hospital, A.O. ICP, Milan, Italy. 3. Child Neuropsychiatry, Vicenza, Italy. 4. Child Neuropsychiatric Unit, Civile Hospital, Brescia, Italy. 5. Pediatric Unit, Ca' Foncello Hospital, Treviso, Italy. 6. Department of Pediatrics, Regional Hospital of Bolzano, Bolzano, Italy. 7. Child Neuropsychiatry, Ospedale Maggiore, Novara, Italy. 8. Department of Neurology, Alessandro Manzoni Hospital, Lecco, Italy. 9. Division of Neonatology, Santa Maria della Misericordia Hospital Udine, Italy. 10. Child Neurology and Clinical Neurophysiology, Pediatric University Hospital, Padua, Italy. 11. Unit of Child Neuropsychiatry, University of Verona, Verona, Italy.
Abstract
BACKGROUND: Neonatal seizures are a risk factor for later epilepsy and their etiology is known to be implicated in the outcome but, little is known about this issue in the subgroup of seizures symptomatic of perinatal arterial ischemic stroke. The aim of this study was to describe the long term risk of epilepsy after electroencephalographic confirmed neonatal seizures symptomatic of perinatal arterial ischemic stroke. DESIGN/SUBJECT: Fifty-five patients with electroclinical ictal data, vascular territory confirmed by neuroimaging and a minimum follow up of 3.5 years were identified from a multi-centre prospective neonatal seizures registry. Primary outcome was occurrence of post-neonatal epilepsy. The association of outcome with family history of epilepsy, gender, location of the infarct, neonatal clinical and electroencephalogram data were also studied. RESULTS: During a mean follow up of 8 years and 5 months, 16.4% of the patients developed post neonatal epilepsy. The mean age at first post neonatal seizure was 4 years and 2 months (range 1-10 years and 6 months). Location of the infarct was the only statistically significant risk factor (p=0.001); epilepsy was more represented in males but the difference was not statistically significant. CONCLUSIONS: Neonatal seizures symptomatic of perinatal arterial ischemic stroke had lower risk and later onset of post-neonatal epilepsy, compared to seizures described in the setting of other perinatal brain insults. Our data have implications for counseling to the family at discharge from neonatal intensive care unit.
BACKGROUND:Neonatal seizures are a risk factor for later epilepsy and their etiology is known to be implicated in the outcome but, little is known about this issue in the subgroup of seizures symptomatic of perinatal arterial ischemic stroke. The aim of this study was to describe the long term risk of epilepsy after electroencephalographic confirmed neonatal seizures symptomatic of perinatal arterial ischemic stroke. DESIGN/SUBJECT: Fifty-five patients with electroclinical ictal data, vascular territory confirmed by neuroimaging and a minimum follow up of 3.5 years were identified from a multi-centre prospective neonatal seizures registry. Primary outcome was occurrence of post-neonatal epilepsy. The association of outcome with family history of epilepsy, gender, location of the infarct, neonatal clinical and electroencephalogram data were also studied. RESULTS: During a mean follow up of 8 years and 5 months, 16.4% of the patients developed post neonatal epilepsy. The mean age at first post neonatal seizure was 4 years and 2 months (range 1-10 years and 6 months). Location of the infarct was the only statistically significant risk factor (p=0.001); epilepsy was more represented in males but the difference was not statistically significant. CONCLUSIONS:Neonatal seizures symptomatic of perinatal arterial ischemic stroke had lower risk and later onset of post-neonatal epilepsy, compared to seizures described in the setting of other perinatal brain insults. Our data have implications for counseling to the family at discharge from neonatal intensive care unit.
Authors: Lori L Billinghurst; Lauren A Beslow; Nicholas S Abend; Michael Uohara; Laura Jastrzab; Daniel J Licht; Rebecca N Ichord Journal: Neurology Date: 2017-01-13 Impact factor: 9.910