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One-year follow-up of infants with abstinence-associated seizures
T M Doberczak1, S Shanzer, R Cutler
1Department of Pediatrics, Beth Israel Medical Center, Mount Sinai School of Medicine, New York, NY 10003.
Insights
Neonatal abstinence-associated seizures in infants show a favorable short-term prognosis. Neurodevelopmental assessments and electroencephalograms often normalize within the first year of life.
Area of Science:
- Neonatology
- Neurodevelopmental Pediatrics
- Pediatric Neurology
Background:
- Neonatal abstinence syndrome (NAS) can lead to seizures.
- The neurodevelopmental outcomes for infants experiencing these seizures are not well-established.
- Understanding the prognosis is crucial for clinical management.
Purpose of the Study:
- To assess the neurodevelopmental outcomes of infants with neonatal abstinence-associated seizures.
- To evaluate changes in neurologic examinations and electroencephalograms (EEGs) over the first year of life.
- To compare developmental trajectories with passively addicted infants and population norms.
Main Methods:
- Neurodevelopmental assessments were performed on 14 infants with neonatal abstinence-associated seizures.
- Neurologic examinations and EEGs were tracked during the first year of life.
- Bayley Scales of Infant Development were used for developmental scoring.
Main Results:
- Most infants showed improvement in neurologic examination findings and EEG abnormalities over time.
- Bayley developmental scores remained within normal limits for the cohort.
- Outcomes did not differ significantly from passively addicted infants without seizures or population norms.
Conclusions:
- Neonatal abstinence-associated seizures appear to have a favorable short-term neurodevelopmental prognosis.
- Neurologic and EEG improvements suggest potential neurotransmitter replenishment.
- This contrasts with the prognosis of neonatal seizures from other etiologies.
Abstract:
Fourteen infants with neonatal abstinence-associated seizures were assessed neurodevelopmentally during the first year of life. Despite abnormal neurologic examination results in eight of 12 infants at 2 to 4 months of age, nine of 12 infants had normal neurologic examination results at follow-up (two infants were unavailable for follow-up; one infant died of acquired immunodeficiency syndrome). Nine neonatal electroencephalograms were abnormal; seven of eight of these abnormal tracings normalized during the follow-up period. Bayley developmental scores remained normal during the first year of life and did not differ from either passively addicted infants without seizures or from published population norms. This short-term favorable prognosis for abstinence-associated seizures differs from that associated with neonatal seizures due to other causes. This observed improvement in neurologic function may be based on replenishment of neurotransmitters following transient depletion in the neonatal period.