This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Background: Although most children with status epilepticus have a good prognosis, its effects on newborns are unclear.
Objective: We compare the neurodevelopmental consequences of recurrent seizures and status epilepticus in newborns.
Methods: One hundred six newborns with video-EEG–confirmed seizures, consecutively admitted to the neonatal intensive care unit of the University of Parma between January 1999 and December 2004, were enrolled in the study. Fifty-one were preterm and 55 were full-term newborns. Neonatal status epilepticus was defined as continuous seizure activity for at least 30 minutes or recurrent seizures lasting a total of >30 minutes without definite return to the baseline neurologic condition of the newborn between seizures. Neurologic outcome was assessed at 24 months of corrected age.
Results: Thirty-six newborns had a normal outcome, 20 died, and 50 presented an adverse outcome. All but 1 of the 26 subjects with neonatal status epilepticus had an adverse outcome. Birth weight, severely abnormal cerebral ultrasound scans, and status epilepticus were independent predictors of abnormal outcome. Depending on gestational age (GA), neonatal status epilepticus seems to be a risk factor of adverse outcome in full-term newborns (GA ≥ 37 weeks: odds ratio [OR] 20.312, 95% CI 2.417 to 170.679, p = 0.006), and a risk factor of epilepsy in early preterm and full-term newborns (GA ≤ 29 weeks: OR 10.500, 95% CI 1.211 to 91.026, p = 0.033; GA ≥ 37 weeks: OR 6.517, 95% CI 1.321 to 32.148, p = 0.021).
Conclusion: Newborns with status epilepticus are at high risk of severe neurologic disability and postneonatal epilepsy. This is particularly evident in early preterm and full-term infants.
Glossary
- GA=
- gestational age;
- IVH=
- intraventricular hemorrhage;
- NICU=
- neonatal intensive care unit;
- NS=
- not significant;
- OR=
- odds ratio;
- PVL=
- periventricular leukomalacia;
- RS=
- recurrent seizures;
- SE=
- status epilepticus;
- US=
- ultrasound.
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
