Perinatal Hypoxic-hypoglycemic Injury and Epilepsy: A Comprehensive Analysis of Clinical and Laboratory Data in...

Area of Science:

• Neurology
• Neonatal Medicine
• Epilepsy Research

Background:

• Perinatal hypoxia and/or hypoglycemia (PHH) is a significant cause of neonatal mortality and long-term neurological deficits.
• Survivors of PHH can experience motor and cognitive impairments, visual disturbances, and seizures.
• Limited data exists on the long-term seizure course, electroencephalogram (EEG), and magnetic resonance imaging (MRI) findings in adults with PHH-related epilepsy.

Purpose of the Study:

• To investigate the clinical characteristics and seizure outcomes in adult patients with epilepsy resulting from PHH.
• To identify factors associated with seizure freedom in this patient population.
• To analyze the correlation between EEG and MRI findings and seizure outcomes.

Main Methods:

• Retrospective study of 41 adult patients with epilepsy attributed to PHH.
• Data extraction included demographics, clinical features, seizure types/frequency, antiseizure medications, EEG, and MRI findings.
• Statistical analysis was performed to identify variables associated with seizure freedom (defined as seizure-free for ≥1 year).

Main Results:

• The median age of patients was 32 years; 88% had bilateral cerebral lesions, primarily in posterior regions.
• Nearly 80% experienced focal to bilateral tonic-clonic seizures, and 60% were on polytherapy.
• Half of the patients achieved seizure freedom, and 75% showed decreased seizure frequency over time. Older age at seizure onset was the sole predictor of seizure freedom (P=.034).

Conclusions:

• Approximately 50% of adult epilepsy patients with PHH history can achieve seizure freedom, with most experiencing reduced seizure frequency.
• Cranial MRI and EEG findings do not correlate with seizure outcomes in this cohort.
• Older age at seizure onset is the only identified factor associated with achieving seizure freedom.