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Neonatal seizures--recent aspects.

M Andre1, N Matisse, P Vert

  • 1Service de Médecine Néonatale, Maternité Régionale, Nancy, France.

Neuropediatrics
|November 1, 1988
PubMed
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Neonatal seizures, often caused by acute fetal distress, impact infant prognosis. Early treatment cessation showed no adverse effects, with better outcomes for isolated crises versus status epilepticus.

Area of Science:

  • Neonatal neurology
  • Pediatric epilepsy

Background:

  • Neonatal seizures are a significant concern with varying etiologies and prognoses.
  • Understanding the long-term outcomes of neonatal seizures is crucial for clinical management.

Purpose of the Study:

  • To analyze the neonatal characteristics and long-term prognosis of seizures in a cohort of 71 neonates.
  • To identify etiological factors and their impact on seizure outcomes.
  • To evaluate the relationship between seizure type (status epilepticus vs. isolated crises) and neurological sequelae.

Main Methods:

  • Retrospective analysis of 71 neonates with seizures between March 1980 and June 1981.
  • Categorization of neonates into term and preterm groups.
  • Etiological investigation, including assessment for acute fetal distress and intracranial hemorrhages.

Related Experiment Videos

  • Follow-up of survivors for at least two years to assess neurological outcomes, including cerebral palsy, mental retardation, and epilepsy.

    • Main Results:

    • Acute fetal distress and intracranial hemorrhages were major etiologies, particularly in term infants.
    • Fifteen neonates (21.1%) died during the neonatal period.
    • Among 56 survivors, 24.3% of term and 31.6% of preterm infants experienced neurological sequelae.
    • Outcomes were significantly better for isolated crises (78% normal) compared to status epilepticus (53% normal).
    • Prognosis for hypoxic-ischemic seizures was favorable if seizures lasted less than two days.

    Conclusions:

    • Neonatal seizures, especially those linked to acute fetal distress, carry a significant risk of neurological sequelae.
    • The type of seizure (isolated crises vs. status epilepticus) is a critical determinant of long-term prognosis.
    • Early discontinuation of treatment post-resolution of seizures and underlying disease appears safe and effective.