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Epilepsy Frequency and Risk Factors Three Years After Neonatal Seizures
Pelin Altınbezer1, Rüya Çolak2, Şebnem Çalkavur2
1Department of Pediatrics, Dr. Behçet Uz Children's Education and Research Hospital, University of Health Sciences Turkey, Izmir, Turkey.
Insights
Neonatal seizures are a significant risk factor for epilepsy. Over one-third of infants with neonatal seizures developed epilepsy, with family history and neurological findings being key indicators.
Area of Science:
- Neurology
- Pediatrics
- Epileptology
Background:
- Neonatal seizures are a major risk factor for developing epilepsy.
- Early identification of risk factors is crucial for timely diagnosis, treatment, and improved prognosis in children.
- Understanding epilepsy development post-neonatal seizures is a significant clinical concern.
Purpose of the Study:
- To determine the frequency of epilepsy in children with a history of neonatal seizures.
- To identify risk factors associated with the development of epilepsy following neonatal seizures.
Main Methods:
- Retrospective review of hospital records for 228 infants experiencing neonatal seizures.
- Assessment of epilepsy development and risk factors at 36 months of age.
Main Results:
- Epilepsy was diagnosed in 40.8% of the cases.
- Significant risk factors identified included family history of epilepsy, abnormal neurological findings, and use of multiple antiepileptic drugs.
- Multivariate analysis confirmed family history, abnormal neurological exam at discharge, and use of at least two antiepileptic drugs as independent risk factors.
Conclusions:
- Neonatal seizures are associated with epilepsy in over one-third of cases.
- Infants with a family history of epilepsy, abnormal neurological findings at discharge, or on multiple antiepileptic drugs require closer monitoring for epilepsy development.
- These findings aid in risk stratification and targeted surveillance for epilepsy in high-risk infants.
Background:
Neonatal seizures, one of the main risk factors for the development of epilepsy, remain a clinical concern. In children with neonatal seizures, early recognition of risk factors is important for the early diagnosis and appropriate treatment of epilepsy and for improving prognosis. In this study, we aimed to determine the frequency of and the risk factors for the development of epilepsy in patients with neonatal seizures.
Methods:
The hospital files of 228 children who experienced seizures in the neonatal period were reviewed. The frequency of epilepsy and risk factors for the development of epilepsy were determined at age 36 months.
Results:
Epilepsy was diagnosed in 40.8% of the cases. Univariate analysis revealed family history of epilepsy, parental consanguinity, abnormal neurological examination findings, microcephaly, unresponsiveness to antiepileptic drugs or antiseizure medication, use of more than one antiepileptic drugs to antiseizure medication at discharge, status epilepticus, electroencephalography abnormalities, abnormal neuroimaging findings, invasive ventilation requirement, myoclonic seizures, central nervous system malformation, and congenital metabolic disease as risk factors for the development of epilepsy. Of these, a family history of epilepsy, abnormal neurological examination findings at discharge, and use of at least two antiepileptic drugs to antiseizure medication at discharge were found as independent risk factors in multivariate analysis.
Conclusions:
Neonatal seizures appear to be associated with epilepsy in more than one-third of the patients. Of the newborns with seizures, those with a family history of epilepsy, abnormal neurological examination findings at discharge, and those using at least two antiepileptic drugs to antiseizure medication at discharge should be monitored more carefully for the development of epilepsy.
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