| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Children’s Hospital Medical Center (Dr. McBride), Akron, Ohio; and the University of Rochester School of Medicine (Drs. Laroia and Guillet), Children’s Hospital at Strong, Rochester, New York.
Address correspondence and reprint requests to Dr. Margaret C. McBride, Division of Child Neurology, Children’s Hospital Medical Center, One Perkins Square, Akron, OH 44308.
OBJECTIVE: To quantify the number, duration, and intensity of electrographic seizures (ESz) in neonates and to compare the outcome of neonates with ESz with those who were at risk but did not have ESz recorded.
METHODS: The EEG and outcome data were reviewed from 68 infants who met at-risk criteria for neonatal seizures and underwent prolonged continuous EEG monitoring. Forty infants had ESz. The control group contained 28 infants monitored for at least 18 hours and found not to have ESz. Outcomes for both groups were evaluated using hospital and follow-up clinic records and a standardized telephone interview.
RESULTS: The etiology of ESz included asphyxia (n = 23), stroke (n = 7), and other (n = 10, intraparenchymal, subdural, and subarachnoid bleeding; meningitis; sepsis; hyponatremia; and unknown). The cumulative recorded ESz duration was 8 minutes to 30 hours. Forty-three percent of infants with ESz spent 38 minutes to 32 hours in electrographic status. Despite doses of 40 mg/kg of phenobarbital and 20 mg/kg of phenytoin, 30% of infants continued to have ESz. Ten infants with ESz and one without died from causes related to neurologic instability. The occurrence of ESz was correlated with microcephaly (p = 0.04), severe cerebral palsy (CP) (p = 0.03), and failure to thrive (p = 0.03). In the subgroup of infants with asphyxia, those with ESz were more likely to die of neurologic causes (p = 0.02) and have microcephaly (p = 0.05) or severe CP (p = 0.04). Additionally, those with the greatest number of ESz were more likely to have these severe outcomes.
CONCLUSION: The authors’ data indicate an association between the amount of electrographic seizure activity and subsequent mortality and morbidity in at-risk infants in general and in infants with perinatal asphyxia. Only with more effective treatment of neonatal electrographic seizures can their potential contribution to poor neurodevelopmental outcome, independent of degree of insult, be ascertained.
This article has been cited by other articles:
|
|
 |
|
  U. M. Reddy, R. A. Filly, and J. A. Copel Prenatal Imaging: Ultrasonography and Magnetic Resonance Imaging Obstet. Gynecol., July 1, 2008; 112(1): 145 - 157. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Sirsi, S. Nangia, J. LaMothe, B. E. Kosofsky, and G. E. Solomon Successful Management of Refractory Neonatal Seizures With Midazolam J Child Neurol, June 1, 2008; 23(6): 706 - 709. [Abstract] [PDF]
|
|
|
|
 |
|
 D. K. Shah, M. T. Mackay, S. Lavery, S. Watson, A. S. Harvey, J. Zempel, A. Mathur, and T. E. Inder Accuracy of Bedside Electroencephalographic Monitoring in Comparison With Simultaneous Continuous Conventional Electroencephalography for Seizure Detection in Term Infants Pediatrics, June 1, 2008; 121(6): 1146 - 1154. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Pisani, C. Copioli, C. Di Gioia, E. Turco, and L. Sisti Neonatal Seizures: Relation of Ictal Video-Electroencephalography (EEG) Findings With Neurodevelopmental Outcome J Child Neurol, April 1, 2008; 23(4): 394 - 398. [Abstract] [PDF]
|
|
|
|
|
|
R. L. Khan, M. Lahorgue Nunes, L. F. Garcias da Silva, and J. C. da Costa Predictive Value of Sequential Electroencephalogram (EEG) in Neonates With Seizures and Its Relation to Neurological Outcome J Child Neurol, February 1, 2008; 23(2): 144 - 150. [Abstract] [PDF]
|
|
|
|
 |
|
 D. Dlugos and J. I. Sirven Prognosis of neonatal seizures: "It's the etiology, Stupid" or is it? Neurology, November 6, 2007; 69(19): 1812 - 1813. [Full Text] [PDF]
|
|
|
|
|
|
R. A. Shellhaas, A. I. Soaita, and R. R. Clancy Sensitivity of Amplitude-Integrated Electroencephalography for Neonatal Seizure Detection Pediatrics, October 1, 2007; 120(4): 770 - 777. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. G.M. van Rooij, L. S. de Vries, S. Handryastuti, D. Hawani, F. Groenendaal, A. C. van Huffelen, and M. C. Toet Neurodevelopmental Outcome in Term Infants With Status Epilepticus Detected With Amplitude-Integrated Electroencephalography Pediatrics, August 1, 2007; 120(2): e354 - e363. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. Wyatt, P. D. Gluckman, P. Y. Liu, D. Azzopardi, R. Ballard, A. D. Edwards, D. M. Ferriero, R. A. Polin, C. M. Robertson, M. Thoresen, et al. Determinants of Outcomes After Head Cooling for Neonatal Encephalopathy Pediatrics, May 1, 2007; 119(5): 912 - 921. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Cherian, J. H. Blok, R. M. Swarte, P. Govaert, and G. H. Visser Heart rate changes are insensitive for detecting postasphyxial seizures in neonates Neurology, December 26, 2006; 67(12): 2221 - 2223. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. C. Toet, P. M.A. Lemmers, L. J. van Schelven, and F. van Bel Cerebral Oxygenation and Electrical Activity After Birth Asphyxia: Their Relation to Outcome Pediatrics, February 1, 2006; 117(2): 333 - 339. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L G M van Rooij, M C Toet, D Osredkar, A C van Huffelen, F Groenendaal, and L S de Vries Recovery of amplitude integrated electroencephalographic background patterns within 24 hours of perinatal asphyxia Arch. Dis. Child. Fetal Neonatal Ed., May 1, 2005; 90(3): F245 - f251. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. R. Castro Conde, A. A. Hernandez Borges, E. D. Martinez, C. G. Campo, and R. P. Soler Midazolam in neonatal seizures with no response to phenobarbital Neurology, March 8, 2005; 64(5): 876 - 879. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Olischar, K. Klebermass, S. Kuhle, M. Hulek, C. Kohlhauser, E. Rucklinger, A. Pollak, and M. Weninger Reference Values for Amplitude-Integrated Electroencephalographic Activity in Preterm Infants Younger Than 30 Weeks' Gestational Age Pediatrics, January 1, 2004; 113(1): e61 - 66. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G B Boylan, J M Rennie, R M Pressler, G Wilson, M Morton, and C D Binnie Phenobarbitone, neonatal seizures, and video-EEG Arch. Dis. Child. Fetal Neonatal Ed., May 1, 2002; 86(3): F165 - F170. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
