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Subsequent epilepsy in very-low-birthweight infants: a long-term follow-up study from birth
T Ishikawa1, S Kishi, K Inukai
1Department of Pediatrics, Nagoya City University Medical School, Japan.
Insights
Very-low-birthweight (VLBW) survivors with epilepsy often experience severe handicaps. These children frequently had complications like premature birth and low Apgar scores.
Area of Science:
- Neonatalogy
- Pediatric Neurology
- Developmental Pediatrics
Background:
- This study investigated the long-term outcomes of very-low-birthweight (VLBW) infants.
- The cohort included 197 survivors from 290 VLBW infants admitted to a neonatal intensive care unit between 1977 and 1982.
- Follow-up extended to at least 6 years of age, with a mean of 10 years and 6 months.
Observation:
- Epilepsy was diagnosed in 8 (4.1%) of the VLBW survivors.
- Seizure types included generalized, unilateral, and partial seizures.
- Two children had active, poorly controlled epilepsy, while three had a history of seizures but were off antiepileptic drug (AED) treatment.
Findings:
- The majority (5 of 8) of VLBW children with epilepsy were severely multiply handicapped.
- Children with epileptic seizures had significantly lower gestational age (< 27 weeks) and birth weight (< 1,000 g).
- Severe perinatal complications, indicated by Apgar scores < 4 at 5 minutes and the need for long-term oxygen, were more common in those with epilepsy.
Implications:
- Early identification of VLBW infants at risk for epilepsy is crucial.
- Understanding the association between perinatal factors and epilepsy can inform preventative strategies.
- This research highlights the significant neurodevelopmental challenges faced by VLBW survivors with epilepsy.
Abstract:
We studied 197 survivors of 290 very-low-birthweight (VLBW, < 1,500 g) infants admitted to our neonatal intensive care unit from 1977 through 1982. The children were all followed until at least age 6 years (mean 10 years 6 months). Eight children (4.1%) had epilepsy: 5 had generalized, 2 had unilateral, and 1 had partial seizures. Two (1.0%) had active and poorly controlled epilepsy. Three had a history of epileptic seizures, but none for > or = 6 years, and 3 were no longer receiving antiepileptic drug (AED) treatment. Most (5 of 8) were severely multiply handicapped. As compared with VLBW children without epileptic seizures and neurodevelopmental abnormalities, VLBW children with epileptic seizures had a gestational age < 27 weeks, a weight < 1,000 g, severe perinatal complications as indicated by an Apgar score of < 4 at 5 min, and the need for long-term oxygen administration.