Neonatal seizures: analysis of clinical and neurophysiological characteristics and its relationship with the incidence of epilepsy in a cohort of newborns

THESES

NEONATAL SEIZURES: ANALYSIS OF CLINICAL AND NEUROPHYSIOLOGICAL CHARACTERISTICS AND ITS RELATIONSHIP WITH THE INCIDENCE OF EPILEPSY IN A COHORT OF NEWBORNS (ABSTRACT)^*. DISSERTATION. PORTO ALEGRE, 2000.

LUIS FERNANDO GARCIAS DA SILVA^**

Background: The technological advances in perinatal care have been promoting the survival of preterm and term newborns. Morbidity, however, remains high, determining serious neurological sequelae, including epilepsy.

Objectives: To study the incidence-density (ID) of epilepsy in a population of newborns inpacients with neonatal seizures. To describe possible aetiological factors related to neonatal seizures as well as neurophysiological abnormalities observed. To relate clinical and neurophysiological variables that could influence pos-natal epilepsy development.

Design: Retrospective and prospective cohort study.

Method: A hundred twenty seven newborns inpatients (preterm and term), at The Neonatal Intensive Care Unit of São Lucas Hospital, PUCRS - Brazil. The time period analyzed goes from January 1987 to Decembre 1997. All of them with clinically defined seizures. Data of gestation, perinatal period and neonatal seizures were obtained retrospectively. Polygraphic recordings (PR) were analyzed by experts in neonatal EEG-tracings. Detailed questionnaires were prospectively collected for all infants with neonatal seizures, after informed consent.

Results: The ID of epilepsy in 12 and 36 follow-up months was 22% and 28.3% respectively. Metabolic disturbances and asphyxia were the most frequent aetiological factors observed. Polygraphic recordings were obtained in 110 newborns and considered normal in 14 (12.7%) and abnormal in 96 (87.3%). Ictal discharge patterns were observed in 10 PR , abnormal paroxysmal patterns with or without ictal correlations in 74 PR and background abnormalities or EEG dysmaturity in 47 PR. Anticonvusants during the neonatal period and central nervous system (CNS) infection were associated to pos-natal epilepsy. Inter-ictal normal neurological examination and normal PR as well, were related to good outcome in this study.

Conclusions: The ID of epilepsy in newborns with neonatal seizures was elevated. Metabolic disturbances and asphyxia were the most frequent aetiological factors. Normal inter-ictal neurological examinations as well as PR have shown good outcome. CNS infection and the need for anticonvulsants therapy during neonatal period led to negative follow-up in this cohort.

Key words: seizures, newborn, epilepsy, cohort study.

**Address: Serviço de Neurologia do Hospital São Lucas da PUCRS, Avenida Ipiranga 6690 sala 220, 90 610-000 Porto Alegre RS, Brasil.

*

Crises convulsivas neonatais: análise das características clínicas, neurofisiológicas e sua relação com a incidência de epilepsia em uma coorte de recém-nascidos. Disertação de Mestrado, Pontifícia Universidade Católica do Rio Grande do Sul (Área: Neurociências). Orientadora: Magda Lahorgue Nunes

Datas de Publicação

• Publicação nesta coleção
  06 Abr 2001
• Data do Fascículo
  Mar 2001