Seizure-like events leading to hospital referrals in infants: A retrospective population-based study

Area of Science:

• Pediatric Neurology
• Neonatal Seizures
• Developmental Pediatrics

Background:

• Seizure-like events in infants present diagnostic challenges.
• Understanding the etiology and predictors of adverse outcomes is crucial for early intervention.

Purpose of the Study:

• To determine the causes and outcomes of infant seizure-like events requiring hospital referral.
• To identify early predictors for epilepsy and delayed neurodevelopment in infants.

Main Methods:

• A population-based study in Norway identified infants up to one year old with seizure-like events or abnormal electroencephalography (EEG) findings.
• Hospital records were reviewed up to 1.5 years of age to ascertain diagnoses and outcomes.

Main Results:

• The one-year prevalence of seizure-like events was 1.5%. Epilepsy was diagnosed in 17% of cases, while 57% had non-epileptic paroxysmal events (NEPE).
• Neurodevelopmental delay occurred in 21% of infants. Abnormal brain MRI, abnormal initial EEGs, and neonatal care were associated with increased risk of epilepsy and delayed development.
• Younger age at event onset increased the risk of delayed development, while situation-related factors decreased epilepsy risk.

Conclusions:

• Seizure-like events are frequent in infants, with most cases not being epilepsy.
• Detailed clinical information, including anamnestic clues and event descriptions, aids in predicting adverse outcomes such as epilepsy or neurodevelopmental delay.