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Published on: September 20, 2024
Prognosis of patients with seizures occurring in the first 2 years
Sakir Altunbaşak1, Faruk Incecik, Ozlem Hergüner
1Department of Pediatric Neurology, Medical Faculty, Cukurova University, Adana, Turkey. sakira@cu.edu.tr
Insights
Infantile spasms and neurological abnormalities predict poor outcomes in young children with seizures. Factors like perinatal anoxia and multiple antiepileptic drugs also indicate unfavorable epilepsy prognosis.
Area of Science:
- Pediatric Neurology
- Epileptology
- Developmental Neuroscience
Background:
- Seizures in infants (1-24 months) have variable prognoses.
- Identifying predictive factors for epilepsy, development, and neurological status is crucial.
Purpose of the Study:
- To determine the prognosis of epilepsy, developmental outcome, and neurological status in patients with seizure onset between 1 and 24 months of age.
- To identify predictive factors associated with unfavorable outcomes.
Main Methods:
- Retrospective analysis of 75 patients with early-onset seizures.
- Univariate and multivariate analyses to identify risk factors.
Main Results:
- Neurological abnormality and polytherapy (multiple antiepileptic drugs) significantly predicted poor developmental outcomes.
- Epileptic activity on electroencephalography (EEG) and polytherapy predicted adverse neurological status.
- Perinatal anoxia, infantile spasms, and status epilepticus were significant predictors of poor epilepsy prognosis.
Conclusions:
- Neurological abnormality, polytherapy, infantile spasms, status epilepticus, and perinatal anoxia are key unfavorable predictive factors for early-onset seizures.
- These factors are critical for assessing prognosis in infants and young children.
Abstract:
The aim of this study is to determine the prognosis of patients with seizure onset from 1 to 24 months of age in respect to epilepsy, developmental outcome, and neurological status. It also aims to determine predictive factors regarding an unfavorable prognosis. Seventy-five patients were retrospectively analyzed. Univariate analysis revealed the following findings: (1) mental retardation at initial admission, abnormal neurological finding, infantile spasm, use of more than 1 antiepileptic drug, epileptic activity on electroencephalography (EEG) of neonatal seizure, and perinatal anoxia were significant risk factors with regard to developmental outcome; (2) mental retardation at initial admission, abnormal neurological finding, infantile spasm, use of more than 1 antiepileptic drug, epileptic activity on EEG, symptomatic etiology, history of neonatal seizure, and perinatal anoxia were significant risk factors regarding neurological status; and (3) mental retardation at initial admission, neurological abnormality, infantile spasm, use of more than 1 antiepileptic drug, epileptic activity on EEG, status epilepticus, symptomatic etiology, seizure frequency of more than once per week, history of perinatal anoxia, and neonatal seizure were significant risk factors regarding epilepsy prognosis. In addition, multivariate analysis revealed that neurological abnormality and use of more than 1 antiepileptic drug were significant for developmental outcome, that epileptic activity on EEG and use of more than 1 antiepileptic drug were significant for neurological status, and that perinatal anoxia, infantile spasm, and status epilepticus were significant for epilepsy prognosis. These findings suggest that neurological abnormality, use of more than 1 antiepileptic drug, infantile spasm, status epilepticus, and perinatal anoxia are unfavorable predictive risk factors regarding the prognosis of patients with seizures that have an onset from 1 to 24 months of age.
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