Predictive factors and prognostic value for status epilepticus in newborns
Zeynep Gokce-Samar1, Karine Ostrowsky-Coste1, Dominique Gauthier-Morel1
1Epileptology, Sleep Disorders and Functional Pediatric Neurology, Member of ERN-EpiCARE; HFME, Hospices Civils de Lyon, 59 Boulevard Pinel, Bron, France.
Summary
Two factors predict status epilepticus (SE) in newborns: abnormal neurological exams and hypoglycemia. For isolated seizures, a normal postictal exam indicates a better outcome.
Area of Science:
- Neonatal neurology
- Pediatric epilepsy
- Clinical outcomes research
Background:
- Neonatal seizures require accurate prediction and prognostic evaluation.
- Status epilepticus (SE) and isolated seizures have distinct characteristics and outcomes in newborns.
- Identifying risk factors is crucial for timely intervention and management.
Purpose of the Study:
- To determine predictive factors for neonatal status epilepticus (SE).
- To identify prognostic factors for patient outcomes in newborns with isolated seizures or SE.
- To enhance understanding of seizure management in neonates.
Main Methods:
- Retrospective single-center study (2010-2014) of 91 newborns with neonatal seizures.
- Categorization into SE (n=50) and isolated seizures (n=41) based on seizure duration and recovery.
- Inclusion of perinatal and electroclinical data, with one-year follow-up for outcome evaluation.
Main Results:
- Severely abnormal initial neurological examination (OR 15.7) and hypoglycemia (OR 6.8) were significant predictors of SE, often associated with hypoxic-ischemic encephalopathy.
- SE was a negative prognostic factor in univariate analysis of the global cohort.
- Normal postictal clinical examination was the sole independent positive prognostic factor for newborns with isolated seizures (OR 48.9).
Conclusions:
- A severely abnormal initial neurological examination and hypoglycemia are independent risk factors for developing SE in newborns.
- For neonates experiencing isolated seizures, a normal postictal clinical examination is a positive prognostic indicator.
- These findings aid in risk stratification and management of neonatal seizures.
Keywords:
HypoglycemiaHypoxic-ischemic encephalopathyNeonatal isolated seizuresNeonatal status epilepticusNeurological examinationOutcomeMore Related Videos
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