ABSTRACT

Conclusion:

In the etiology of neonatal seizures, IVH in preterm infants and HIE in term infants were the first. The neurological outcomes of patients who had convulsions in the neonatal period should be followed closely.

Results:

A total of 86 patients (43 preterm and 43 term infants) were included in this study. The most common etiological factors were hypoxic-ischemic encephalopathy (HIE) (35%) in term infants and intraventricular hemorrhage (IVH) in preterm infants (54%). The most common seizure type was subtle seizures in preterm babies and clonic seizures in term babies. The first seizure day was more on the first day and between the 4-7 days in term babies and after seventh days in preterm babies (p <0.05). The onset time of seizures in preterm babies was more after seven days at IVH, and on the first day at HIE (p<0.05). Status epilepticus frequency is higher in preterm (30%) than term (9.3%) (p = 0.015). The response rate to phenobarbital treatment was 71% in term infants and 50% in preterm infants (p = 0.06). According to the criteria (death, epilepsy, hearing loss, autism and gross motor function scale> 2) in our study, the poor prognosis rates were (52%) in term infants and (75%) in preterm infants (p = 0.051).

Materials and Methods:

The files of patients with a diagnosis of neonatal seizure in the NICU between 01/01/2014 and 01/09/2019 were analyzed retrospectively. Gross motor function classification, hearing test results and epilepsy rates were examined for neurological outcomes.

Introduction:

The seizure is one of the most common neurological problems in neonatal intensive care units (NICU). Its frequency and etiology differ between preterm and term babies. This study aimed to investigate the properties, causes, response to treatment, and prognostic factors of neonatal seizures in term and preterm babies.

References

1Tekgul H, Gauvreau K, Soul J, Murphy L, Robertson R, Stewart J, et al. The current etiologic profile and neurodevelopmental outcome of seizures in term newborn infants. Pediatrics 2006;117:1270-80.

2Al-Naddawi MN, Hameed NN, Kadum MJ, Nebal M. Clinical types and possible etiologies of neonatal seizures: A hospital based study. J Fac Med 2011;53:1-5.

3Soul JS. Acute symptomatic seizures in term neonates : Etiologies and treatments. Semin Fetal Neonatal Med 2018;23:1-8.

4Pisani F, Spagnoli C. Acute symptomatic neonatal seizures in preterm neonates: etiologies and treatments. Semin Fetal Neonatal Med 2018;23:191-6.

5Spagnoli C, Falsaperla R, Deolmi M, Corsello G, Pisani F. Symptomatic seizures in preterm newborns: A review on clinical features and prognosis. Ital J Pediatr 2018;44:1-7.

6Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol 1997;39:214-23.

7Bax M, Goldstein M, Rosenbaum P, Leviton A, Paneth N, Dan B, et al. Proposed definition and classification of cerebral palsy, April 2005. Dev Med Child Neurol 2005;47:571-6.

8Wood E, Rosenbaum P. The gross motor function classification system for cerebral palsy: a study of reliability and stability over time. Dev Med Child Neurol 2000;42:292-6.

9Abend NS, Wusthoff CJ. Neonatal seizures and status epilepticus. J Clin Neurophysiol 2012;29:441-8.

10Pavlidis E, Spagnoli C, Pelosi A, Mazzotta S, Pisani F. Neonatal status epilepticus: Differences between preterm and term newborns. Eur J Paediatr Neurol 2015;19:314-9.

11Akisu M, Kumral A, Canpolat FE. Turkish neonatal society guideline on neonatal encephalopathy. Turk Pediatr Ars 2018;53(Suppl 1):32-44.

12Aliefendioğlu D, Çoban A, Hatipoğlu N, Ecevit A, Arısoy AE, Yeşiltepe G, et al. Management of hypoglycemia in newborn: Turkish Neonatal and Pediatric Endocrinology and Diabetes Societies consensus report. Turk Pediatr Ars 2018;53(Suppl 1):224-33.

13Satar M, Engin Arısoy A, Çelik İH. Turkish neonatal society guideline on neonatal infections - diagnosis and treatment. Turk Pediatr Ars 2018;53(Suppl 1):88-100.

14Nair BK, Sharma J, Chaudhary S. Clinicoetiological Profile of Neonatal Seizure in a Newborn Care Unit of a Tertiary Care Teaching Hospital in Northern India. J Clin Neonatol 2020;9:27-31.

1515. Yıldız EP, Tatlı B, Ekici B, Eraslan E, Aydınlı N, Calışkan M, et al. Evaluation of etiologic and prognostic factors in neonatal convulsions. Pediatr Neurol 2012;47:186-92.

16Taksande A M, Vilhekar K, Jain M, Lakra M. Clinico-Biochemical Profile Of Neonatal Seizures. Pediatr Oncall J. 2005;2:68.

17Arican P, Olgac Dundar N, Mete Atasever N, Akkaya Inal M, Gencpinar P, Cavusoglu D, et al. Comparison of the neurocognitive outcomes in term infants treated with levetiracetam and phenobarbital monotherapy for neonatal clinical seizures. Seizure. 2020;80:71-4.

18Kanmaz S, Altun Köroğlu Ö, Terek D, Serin HM, Simsek E, Dokurel Cetin İ, et al. Efficacy of levetiracetam as first line therapy for neonatal clinical seizures and neurodevelopmental outcome at 12 months of age. Acta Neurol Belg 2020 May 18. doi: 10.1007/s13760-020-01366-7.

19Karaoğlu P, Hız S, İşcan B, Polat AI, Ayanoğlu M, Duman N, et al. Intravenous levetiracetam for treatment of seizures in term and preterm neonates. J Pediatr Neurosci 2020;15:15-20.

20Sharpe C, Reiner GE, Davis SL, Nespeca M, Gold JJ, Rasmussen M, et al. Levetiracetam versus phenobarbital for neonatal seizures: A randomized controlled trial. Pediatrics 2020;145:e20193182.

21Meyn DF Jr, Ness J, Ambalavanan N, Carlo WA. Prophylactic phenobarbital and whole-body cooling for neonatal hypoxic-ischemic encephalopathy. J Pediatr 2010;157:334-6.

22Glass HC, Grinspan ZM, Shellhaas RA. Outcomes after acute symptomatic seizures in neonates. Semin Fetal Neonatal Med 2018;23:218-22.

Etiology, Clinic and Prognosis of Seizures in Preterm and Term Neonates: A Retrospective Study

ABSTRACT

References