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Seizures: Classification01:13

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Kinetics describes the rate and path by which a reaction occurs. In contrast, thermodynamics deals with state functions and describes the properties, behavior, and components of a system. It is not concerned with the path taken by the process and cannot address the rate at which a reaction occurs. Although it does provide information about what can happen during a reaction process, it does not describe the detailed steps of what appears on an atomic or a molecular level. On the other hand,...
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Transcutaneous Microcirculatory Imaging in Preterm Neonates
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Outcome in preterm infants with seizures.

Francesco Pisani1, Carlotta Spagnoli2

  • 1Child Neuropsychiatry Unit, Department of Medicine & Surgery, University of Parma, Parma, Italy.

Handbook of Clinical Neurology
|July 21, 2019
PubMed
Summary

Neonatal seizures in preterm infants, often acute and symptomatic, carry significant risks for long-term developmental issues and epilepsy. While mortality has decreased, outcomes remain poor for very premature infants.

Keywords:
Anticonvulsant drugsCerebral palsyEpilepsyNeonatal neurologyNewbornsPrognosis

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Area of Science:

  • Neonatology
  • Pediatric Neurology
  • Developmental Neuroscience

Background:

  • Neonatal seizures are more prevalent in preterm infants and often acute symptomatic.
  • Current management guidelines for preterm neonatal seizures are limited and undifferentiated from those for full-term infants.
  • Mortality rates for preterm infants with seizures have decreased significantly but remain high for extremely preterm infants (gestational age < 28 weeks, birth weight < 1000g).

Purpose of the Study:

  • To review the current understanding of neonatal seizures in preterm newborns.
  • To highlight the significant long-term neurodevelopmental consequences associated with these seizures.
  • To underscore the need for specialized management strategies and further research.

Main Methods:

  • Literature review of studies on neonatal seizures in preterm infants.
  • Analysis of mortality trends and risk factors.
  • Examination of long-term neurodevelopmental outcomes, including epilepsy, cerebral palsy, and cognitive/sensory impairments.

Main Results:

  • Neonatal seizures are a strong predictor of adverse outcomes, including cerebral palsy, epilepsy, intellectual disability, and sensory impairments.
  • The incidence of epilepsy post-seizure is lower in preterm than full-term infants but still significantly elevated compared to the general population.
  • Distinguishing the independent contributions of seizure activity versus underlying etiology and brain injury to long-term outcomes remains challenging.

Conclusions:

  • Neonatal seizures in preterm infants are associated with substantial risks for severe neurodevelopmental disabilities.
  • Despite improved survival, long-term morbidities necessitate targeted research and clinical approaches.
  • Further studies are required to elucidate the specific impact of seizures versus other factors on developmental trajectories.