Neonatal Medicine

The Korean Society of Neonatology (대한신생아학회)
권호 표지

Outcomes of Neonatal Seizures

신생아 경련의 예후

  • Sung, In-Kyung (Department of Pediatrics, Catholic University College of Medicine)
  • 성인경 (가톨릭대학교 의과대학 소아과학교실)
  • Published : 2009.05.31

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Abstract

Seizures are the most common clinical symptom of a neurologic insult and have long been recognized as an obvious marker of brain dysfunction in newborns. Presence of seizures in newborn infants may signify substantial risk for subsequent neurodevelopmental impairment including postneonatal epilepsy and death. The outcomes of seizures in neonates are determined mainly by the etiology of the seizures. Despite the decreasing trend of mortality of neonatal seizures, the prevalence of long-term neurodevelopmental sequelae in survivors has remained unchanged over time. Clinical studies have contributed to identifying significant prognostic factors for neurodevelopmental outcome. The underlying etiology of the seizures and electroencepaphalography background pattern are considered as most reliable early predictors of later neurologic sequelae. However, clinicians managing neonatal seizures are still challenged by difficult therapeutic and prognostic questions because of many unresolved issues in seizure recognition, terminology, relationships to the underlying brain lesion, effect of current management, particularly antiepileptic drugs on long-term outcomes. This review presents the prognosis of neonatal seizures, especially about mortality and neurodevelopmental deficit, and predictors of outcomes.

Keywords

References

  1. Volpe JJ. Neurology of the newborn. 4th ed. Philadelphia: WB Saunders Co, 2001: 178-214.
  2. Thibeault-Eybalin MP, Lortie A. Carmant L. Neonatal seizures: do they damage the brain? Pediatr Neurol 2009;40:175-80. https://doi.org/10.1016/j.pediatrneurol.2008.10.026
  3. Tekgul H, Gauvreau K, Soul .J. Murphy L. Robertson R. Stewart J. et al. The current etiologic profile and neurodevelopmental outcome of seizures in term newborn infants. Pediatrics 2006;117:1270-80. https://doi.org/10.1542/peds.2005-1178
  4. Ronen GM, Buckley D, Penney S, Streiner DL. Long-term prognosis in children with neonatal seizures: a population-based study. Neurology 2007; 69:1816-22. https://doi.org/10.1212/01.wnl.0000279335.85797.2c
  5. Bye AM, Cunningham CA, Chee KY, Flanagan D. Outcome of neonates with electrographically identified seizures, or at risk of seizures. Pediatr Neurol 1997;16:225-31. https://doi.org/10.1016/S0887-8994(97)00019-2
  6. Mizrahi EM, Clancy RR. Neonatal seizures: early-onset seizure syndromes and their consequences for development. Ment Retard Dev Disabil Res Rev 2000;6:229-41. https://doi.org/10.1002/1098-2779(2000)6:4<229::AID-MRDD2>3.0.CO;2-Y
  7. Pisani F, Copioli C, Di Gioia C, Turco E, Sisti L. Neonatal seizures: relation of ictal video-electro-encephalography (EEG) findings with neurodevelopmental outcome. J Child Neurol 2008;23:394-8. https://doi.org/10.1177/0883073807309253
  8. Shin MS, Chang MY, Lee KS. A scoring system to predict the outcome in neonatal seizures. J Korean Child Neurol Soc 2006;14:68-78.
  9. Jung KH, Kim YH, Kwon YS, Jun YH, Kim SK, Son BK. Clinical characteristics of neonatal status epilepticus. Korean J Pediatr 2005;48:1342-7.
  10. Kim CW, Jang CH, Kim HM, Choe BH, Kwon SH. Clinical characteristics and prognosis of neonatal seizures. J Korean Pediatr Soc 2003;46:1253-9.
  11. Kim SK, Lee R, Lee IK, Kim KJ, Hwang YS. Factors related to the outcome of neonatal seizures. J Korean Pediatr Soc 2000;43:267-73.
  12. Park W, Kim DY, Jung CZ, Kim SD. Clinical study of neonatal seizure. J Korean Child Neurol Soc 1998;6:71-82.
  13. Oh KS. Clinical study and prognostic factors of neonatal seizures. J Wonkwang Med Sci 1998;14: 257-67.
  14. Kong BS, Lee RS, Park SK, Park HJ. A clinical study on neonatal seizures. J Korean Pediatr Soc 1991;34:230-9.
  15. Park CY, Yum MK, Choi JH, Hwang YS, Yun CK. A clinical study on neonatal seizures. J Korean Pediatr Soc 1985;28:29-39.
  16. Kim MJ, Lee SJ, Lee K. A clinical study of neonatal convulsion. J Korean Pediatr Soc 1983;26: 640-6.
  17. Kohelet D, Shochat R, Lusky A, Reichman B; Israel Neonatal Network. Risk factors for seizures in very low birth weight infants with periventricular leukomalacia. J Child Neurol 2006;21:965-70. https://doi.org/10.1177/08830738060210111301
  18. Pisani F, Barilli AL, Sisti L, Bevilacqua G, Seri S. Preterm infant with video-EEG confirmed seizures: outcome at 30 months of age. Brain Dev 2008;30: 20-30. https://doi.org/10.1016/j.braindev.2007.05.003
  19. Khan RL, Nunes ML, Garcias da Silva LF, da Costa JC. Predictive value of sequential electroencephalogram(EEG) in neonates with seizures and its relation to neurological outcome. J Child Neurol 2008;23:144-50. https://doi.org/10.1177/0883073807308711
  20. Pisani F, Leali L, Parmigiani S, Squarcia A, Tanzi S, Volante E, et al. Neonatal seizures in preterm infants: clinical outcome and relationship with subsequent epilepsy. J Matern Fetal Neonatal Med 2004;16 Suppl 2:51-3. https://doi.org/10.1080/jmf.16.2.51.53
  21. Holden KR, Mellits ED, Freeman JM. Neonatal seizures I. Correlation of prenatal and perinatal events with outcomes. Pediatrics 1982;70:165-76.
  22. Connell J, Oozeer R, de Vries L, Dubowitz LM, Dubowitz V. Continuous EEG monitoring of neonatal seizures: diagnostic and prognostic considerations. Arch Dis Child 1989;64:452-8. https://doi.org/10.1136/adc.64.4_Spec_No.452
  23. Leijser LM, Vein AA, Liauw L, Strauss T, Veen S, Wezel-Meijler G. Prediction of short-term neurological outcome in full-term neonates with hypoxicischaemic encephalopathy based on combined use of electroencephalogram and neuro-imaging. Neuropediatrics 2007;38:219-27. https://doi.org/10.1055/s-2007-992815
  24. Rees S, Inder T. Fetal and neonatal origins of altered brain development. Early Hum Dev 2005;81: 753-61. https://doi.org/10.1016/j.earlhumdev.2005.07.004
  25. Lombroso CT. Neonatal seizures: gaps between the laboratory and the clinic. Epilepsia 2007;48 Suppl 2: 83-106. https://doi.org/10.1111/j.1528-1167.2007.01070.x
  26. Biagioni E, Mercuri E, Rutherford M, Cowan F, Azzopardi D, Frisone MF, et al. Combined use of electroencephalogram and magnetic resonance imaging in full-term neonates with acute encephalopathy. Pediatrics 2001;107:461-8. https://doi.org/10.1542/peds.107.3.461
  27. Silverstein FS, Jensen FE. Neonatal seizures. Ann Neurol 2007;62:112-20. https://doi.org/10.1002/ana.21167
  28. Brunquell PJ, Glennon CM, DiMario FJ Jr, Lerer T, Eisenfeld L. Prediction of outcome based on clinical seizure type in newborn infants. J Pediatr 2002;140: 707-12. https://doi.org/10.1067/mpd.2002.124773
  29. Mizrahi EM, Kellaway P. Characterization and classification of neonatal seizures. Neurology 1987; 37:1837-44. https://doi.org/10.1212/WNL.37.12.1837
  30. Biagioni E, Ferrari F, Boldrini A, Roversi MF, Cioni G. Electroclinical correlation in neonatal seizures. Eur J Paediatr Neurol 1998;2:117-25. https://doi.org/10.1016/S1090-3798(98)80027-5
  31. Toet MC, Groenendaal F, Osredkar D, van Huffelen AC, de Vries LS. Postnatal epilepsy following amplitude-integrated EEG-detected neonatal seizures. Pediatr Neurol 2005;32:241-7. https://doi.org/10.1016/j.pediatrneurol.2004.11.005
  32. Ortibus EL, Sum JM, Hahn JS. Predictive value of EEG for outcome and epilepsy following neonatal seizures. Electroencephalogr Clin Neurophysiol 1996;98: 175-85. https://doi.org/10.1016/0013-4694(95)00245-6
  33. Scher MS, Hamid MY, Steppe DA, Beggarly ME, Painter MJ. Ictal and interictal electrographic seizure duration in preterm and term neonates. Epilepsia 1993;34:284-8. https://doi.org/10.1111/j.1528-1157.1993.tb02412.x
  34. Legido A, Clancy RR, Berman PH. Neurologic outcome after electroencephalographically proven neonatal seizures. Pediatrics 1991;88:583-96.
  35. Tudehope DI, Harris A, Hawes D, Hayes M. Clinical spectrum and outcome of neonatal convulsions. Aust Paediatr J 1988;24:249-53.
  36. Bergman I, Painter MJ, Hirsch RP, Crumrine PK, David R. Outcome in neonates with convulsions treated in an intensive care unit. Ann Neurol 1983; 14:642-7. https://doi.org/10.1002/ana.410140607
  37. Bo T, Jiang Y, Cao H, Wang J, Wu X. Long-term effects of seizures in neonatal rats on spatial learning ability and N-methyl-D-aspartate receptor expression in the brain. Brain Res Dev Brain Res 2004;152: 137 -42. https://doi.org/10.1016/j.devbrainres.2004.06.011
  38. Miller SP, Weiss J, Barnwell A, Ferriero DM, Latal-Hajnal B, Ferrer-Rogers A, et al. Seizureassociated brain injury in term newborns with perinatal asphyxia. Neurology 2002;58:542-8. https://doi.org/10.1212/WNL.58.4.542
  39. Garcias Da Silva LF, Nunes ML, Da Costa JC. Risk factors for developing epilepsy after neonatal seizures. Pediatr Neurol 2004;30:271-7. https://doi.org/10.1016/j.pediatrneurol.2003.09.015
  40. Temple CM, Dennis J, Carney R, Sharich J. Neonatal seizures: long-term outcome and cognitive development among normal survivors. Dev Med Child Neurol 1995;37:109-18. https://doi.org/10.1111/j.1469-8749.1995.tb11979.x