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Continuous Video Electroencephalogram during Hypoxia-Ischemia in Neonatal Mice
Published on: June 11, 2020
Perinatal Hypoxic-Ischemic Encephalopathy: epileptic and paretic outcome at one year of age
Federico Allemand1, Federica Reale, Marco Sposato
1Dipartimento di Scienze Neurologiche, Psichiatriche e Riabilitative dell'Età Evolutiva "Giovanni Bollea", "SAPIENZA" Università di Roma, Italia (Italy). federico.allemand@uniroma1.it.
Insights
Neonatal parameters like birth weight and early EEG findings can predict the risk of severe neurological outcomes, including cerebral palsy and epilepsy, in infants with perinatal Hypoxic-Ischemic Encephalopathy (HIE). Early identification aids in managing moderate versus severe sequelae.
Area of Science:
- Neonatology
- Neurology
- Pediatric Neurology
Background:
- Perinatal Hypoxic-Ischemic Encephalopathy (HIE) poses significant risks for long-term neurologic deficits.
- Identifying reliable prognostic factors for HIE sequelae is crucial for clinical management.
- Previous studies highlight the need for better prediction of outcomes like Cerebral Palsy (CP) and epilepsy.
Purpose of the Study:
- To identify neonatal factors predicting the risk of Cerebral Palsy (CP) and secondary epilepsy at one year of age in HIE patients.
- To explore correlations between neonatal parameters and the severity of CP and epilepsy.
Main Methods:
- Retrospective analysis of clinical and instrumental data from 32 HIE-affected infants.
- Assessment of outcomes including CP and epilepsy at one year of age.
- Statistical analysis to correlate neonatal parameters with long-term sequelae.
Main Results:
- Birth weight is a significant predictor of overall prognosis; neonates <1.5 kg are at lower risk for both epilepsy and CP.
- Neonatal clinical presentation and early EEG findings correlate with the severity of CP.
- Early onset epilepsy (within 6 months) is associated with more severe CP and epilepsy outcomes.
Conclusions:
- Specific neonatal parameters, including birth weight, clinical pattern, and early EEG, are vital for predicting HIE outcomes.
- These factors help differentiate infants at risk for severe sequelae from those with moderate outcomes.
- Clinical application of these predictive factors can guide early intervention and management strategies.
Background:
The issue concerning neurologic outcome in patients with perinatal Hypoxic-Ischemic Encephalopathy (H.I.E) has inspired many studies which tried to identify adequate prognostic factors. Our work aims to find among neonatal parameters:- factors which help to predict the risk to develop both Cerebral Palsy (CP) and secondary Epilepsy at one year of age in subjects affected by perinatal Hypoxic-Ischemic Encephalopathy,- correlations between the neonatal parameters and the variable severity of above mentioned sequelae.
Methods:
We have recruited 32 subjects, whose history and neuroimages suggested a perinatal H.I.E and we have retrospectively analysed clinical-instrumental parameters at birth and at one year of age.
Results:
At one year cut-off, 9 patients developed both secondary epilepsy and CP (28%), whereas the other subjects showed only motor delay (31%), only secondary epilepsy (3%) or only CP (38%). Patients with both the severest sequelae were essentially term infants (only 2/9 were pre-term infants), with normal weight (only 3 LBW) and 7 of them with early pathologic EEG and neuroimages pointing out cortex injuries (typical of term infants). A statistic analysis showed the following correlations: birth weight and global prognosis (chi2 = 14,03; p = 0,04); neonatal clinical pattern and CP's severity (chi2 = 14,03; p = 0,0009); early EEG and CP's severity (chi2 = 4,32; p = 0,04); epileptic onset age and CP and Epilepsy's severity (F = 16,01; p = 0,005).Birth weight represented a predictive factor of early neurological outcome (<1,5 kg birth weight neonates are not at risk of both epilepsy and CP); neonatal clinical pattern and early EEG were correlated with variable severity of CP; an epileptic exordium in the first 6 months led up to a more severe epileptic and paretic outcome.
Conclusion:
From a clinical point of view it is of crucial importance to have some parameters which enable to discriminate patients at risk of more severe sequelae from those at risk of moderate severity outcome.
