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Electrographic neonatal seizures after infant heart surgery
Robert R Clancy1, Uzma Sharif, Rebecca Ichord
1Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19105, USA. Clancy@email.chop.edu
Epilepsia
|January 22, 2005
Summary
Electrographic neonatal seizures are common in infants after heart surgery, often without visible symptoms. These seizures, while variable, may indicate a need for neuroprotection strategies in future trials.
Area of Science:
- Pediatric Neurology
- Cardiovascular Surgery
- Neonatal Medicine
Background:
- Neonatal seizures are a critical indicator of acute encephalopathy in infants undergoing heart surgery.
- The prevalence and electrographic features of seizures in this population require further elucidation.
Purpose of the Study:
- To characterize electrographic neonatal seizures (ENSs) in infants with congenital heart disease (CHD) post-cardiopulmonary bypass surgery.
- To determine the occurrence, timing, and electrographic patterns of ENSs.
Main Methods:
- Video-electroencephalography (EEG) monitoring for 48 hours post-surgery in 183 infants.
- Analysis of seizure onset, frequency, origin, and response to phenobarbital.
Main Results:
- ENSs occurred in 11.5% of infants, with no clinically apparent seizures observed.
- The mean time to the first ENS was 21 hours, with a mean of 72 seizures per patient over 48 hours.
- Phenobarbital reduced seizure counts by at least 50% in 41.7% of treated infants.
Conclusions:
- ENSs are a frequent, often subclinical, finding in infants following surgical repair of CHD.
- Significant variability in seizure burden exists, with many infants experiencing a high number of seizures.
- ENSs represent a potential outcome measure for neuroprotection studies in this vulnerable group.