Neonatal Seizures: A Review of Outcomes and Outcome Predictors

Area of Science:

• Neonatology
• Neurology
• Pediatric Neurology

Background:

• Neonatal seizures are frequently acute and symptomatic, linked to increased mortality and morbidity.
• While etiology is a key prognostic factor, other elements like gestational age and brain injury severity also influence outcomes.
• Accurate early prognostication requires integrating diverse clinical and instrumental data.

Purpose of the Study:

• To review the outcomes of neonatal seizures, including mortality, epilepsy, cerebral palsy, and intellectual disability.
• To identify risk factors for adverse outcomes, considering clinical, EEG, and neuroimaging findings.
• To examine existing scoring systems for predicting neurological outcomes in neonates with seizures.

Main Methods:

• Systematic literature review of studies on neonatal seizures and their outcomes.
• Analysis of clinical, electroencephalography (EEG), amplitude-integrated EEG (aEEG), and neuroimaging data.
• Evaluation of prognostic scoring systems for neonatal seizures.

Main Results:

• Neonatal seizures are associated with significant risks of mortality, epilepsy, cerebral palsy, and intellectual disability.
• Clinical factors, gestational age, brain damage severity, and EEG characteristics are crucial predictors of outcome.
• Certain EEG and neuroimaging findings correlate with adverse outcomes and treatment resistance.

Conclusions:

• Early and accurate prognostication in neonatal seizures is achievable by combining various clinical and instrumental data.
• Understanding risk factors is essential for guiding management and improving neurodevelopmental outcomes.
• Further research into refining prognostic tools is warranted to optimize care for affected newborns.