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Early Pathological and Magnetic Resonance Detection of Cerebral Injury Using a Rat Model of Neonatal Hypoxic Ischemic Encephalopathy
Published on: October 28, 2022
[Long-term prognosis of children with hypoxic encephalopathy]
Insights
Hypoxic encephalopathy in children often leads to severe physical and mental disabilities, including epilepsy. Prognosis depends on etiology, age at onset, and acute stage severity.
Area of Science:
- Pediatric Neurology
- Neuroscience
- Critical Care Medicine
Context:
- Hypoxic encephalopathy (HE) in children is a serious condition with significant long-term consequences.
- Prognostic data for pediatric HE is limited, hindering effective management and parental counseling.
Purpose:
- To investigate the long-term prognosis and sequelae in 35 children diagnosed with hypoxic encephalopathy.
- To identify factors influencing the severity of disabilities following HE in a pediatric cohort.
Summary:
- This study analyzed 35 children with HE, with onset averaging 5 years 8 months. Common etiologies included drowning, asphyxia, and heart diseases.
- Sequelae were frequent, encompassing physical (28 cases), mental (30 cases), and neurological impairments like epilepsy (16 cases) and higher brain dysfunction (12 cases).
- Severe disabilities were associated with specific etiologies (asphyxia, cardiac issues), age at onset (under 2 or over 13 years), and prolonged, severe consciousness loss.
Impact:
- Findings highlight the serious and often permanent nature of sequelae from pediatric HE, exceeding those of acute encephalopathy.
- Identifies key risk factors for severe outcomes, aiding in risk stratification and targeted interventions for affected children.
Objective:
Reports of the prognosis of hypoxic encephalopathy in children have not been common. We investigated the prognoses in 35 children with hypoxic encephalopathy at more than one year from the onset.
Methods:
The average age of onset was 5 years 8 months, and the present age was 12 years 6 months in all cases. The medical records were reviewed, and the clinical courses during the acute stage, the state of sequelae were investigated.
Results:
The etiologies were drowning 12 cases, asphyxia in 6, heart diseases in 10, respiratory diseases in 2, cardiac arrest in 3, etc. Each etiology showed age-related characterisitics. All cases showed consciousness loss levels of triple-digits on the Japan coma scale. The sequelae comprised physical disabilities in 28 cases, mental disabilities in 30, epilepsy in 16, higher brain dysfunction in 12 especially visiospacial disturbance, etc. The onset of epilepsy was mainly within 3 months after onset of the hypoxic encephalopathy. The types of epileptic seizures were focal seizures in 14 cases and generalized seizures in 12. On average, 2.1 antiepileptic drugs, such as carbamazepine and valproate were prescribed. EEG, brain MRI and brain SPECT showed an extensive range of abnormalities. Severe disabilities depended on the following factors:(1) the etiologies such as asphyxia, congenital heart diseases, cardiac arrest, (2) the age of onset under 2 years or over 13 years, (3) long and severe consciousness loss during the acute stage.
Conclusion:
Though the sequelae of hypoxic encephalopathy were similar to those of acute encephalopathy, the former was more serious than the latter.
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