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[Clinical and electrophysiological evolution of infants presenting with partial seizures before the age of two months
Insights
Neonatal seizures require careful electroclinical correlation. Permanent EEG asymmetry predicts future signs, while isolated EEG abnormalities alone lack prognostic value for cerebral maturation.
Area of Science:
- Pediatric Neurology
- Clinical Neurophysiology
Context:
- Neonatal seizures are a critical concern in infant neurology.
- Early identification and prognosis are vital for long-term outcomes.
Purpose:
- To investigate the electroclinical correlations in neonatal seizures.
- To assess the prognostic value of clinical and EEG findings at different developmental stages.
Summary:
- The study followed 28 infants with various neonatal seizures, performing clinical and electroencephalogram (EEG) evaluations at onset, 1 month, and 4 months.
- Findings indicated that while seizures and critical EEG discharges had limited localizing value, persistent EEG asymmetry preceded clinical signs.
- One-month follow-up highlighted the prognostic significance of neurological signs coupled with EEG abnormalities, whereas isolated EEG changes were not predictive of cerebral maturation.
Impact:
- This research emphasizes the importance of serial electroclinical assessments in managing neonatal seizures.
- Understanding these correlations aids in predicting long-term neurological development and informing early interventions.
Abstract:
The study was carried out on 28 children: 18 with partial seizures in the first five days of life, and among them 4 with status epilepticus; 7 had focal seizures between the first and eight week, 3 generalised tonic seizures with assymetrical EEGs. A clinical and electro-physiological study was carried out at the time of onset, 1 month later and again at 4 months. The results of the clinical and EEG examinations showed: -firstly during the seizures, the gravity of neonatal status epilepticus and of certain EEG patterns, the lack of localising value of seizures and of electroencephalographic critical discharges whereas permanent assymetry of background activity can precede by several months the appearance of clinical signs. -at the examination one month later the prognostic importance of definite neurological signs always associated with EEG abnormalities whereas some isolated EEG abnormalities do not have any prognostic value as far cerebral maturation is concerned. -at the final examination: the possibility after 4 months of age, of focal neurological signs not present at the earlier examinations. This study underlines the importance of precise electroclinical correlations at different developmental stages, specifically at one and four months of age in children with neonatal seizures.