Neonatal seizures in extremely preterm infants with very and extremely low birth weight: prevalence and transformation into structural epilepsy


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Abstract

Objective: To investigate the incidence of neonatal seizures and their transformation into structural epilepsy in children with extremely low birth weight (ELBW) and very low birth weight (VLBW). Materials and Methods: This retrospective analysis of the medical records included 297 patients born at 25-32 weeks' gestation with birth weight less than 1499 g, including 29 children with neonatal seizures. After discharge, patients with neonatal seizures were under outpatient supervision by a neurologist. Electroencephalography (EEG) was performed at the corrected age (CA) of 2, 6, 9, 12, 18, 24, and 36 months. Neurological outcome was assessed at CA of 36 months. Results: Neonatal seizures were diagnosed in 29 patients (9.8%). Amplitude-integrated EEG (aEEG) and multichannel EEG in the neonatal period were performed in 246 patients. Among children with neonatal seizures, epileptiform activity on the aEEG and EEG tracings were observed in 16 (55%) and 20patients (69%), respectively. Among patients with clinical manifestations of neonatal seizures (n=29), antiepileptic therapy was administered to 26 patients (89.7%). At CA of 6 months of treatment, six patients with neonatal seizures showed normalization of EEG data, which was an indication for discontinuation of antiepileptic therapy. According to EEG findings, four children retained epileptiform activity without convulsions; one child developed repeated epileptic seizures. These patients were diagnosed with structural epilepsy. Antiepileptic therapy was continued. All patients with neonatal structural epilepsy had status seizures. Conclusion: Neonatal seizures were diagnosed in 9.8% of patients. Compared to aEEG, EEG is more sensitive in detecting epileptiform activity. Structural epilepsy was diagnosed in children with neonatal seizures, requiring anticonvulsant therapy for more than three years. The study findings show the importance of a comprehensive neurological examination and follow-up of patients with neonatal seizures.

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About the authors

Ivan A. Suvorov

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: iwan.suv@mam.ru
Neurologist at the Department of Pediatric Counselling of the Institute of Neonatology and Pediatrics

Dzhenneta Yu. Amirkhanova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: djenn83@mail.ru
Neurologist at the Department of Pediatric Counselling of the Institute of Neonatology and Pediatrics

Anna V. Degtyareva

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: annadim@yahoo.com
Dr. Med. Sci., Professor, Head of Pediatric Department

Dmitriy N. Degtyarev

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: degtiarev@oparina4.ru
Dr. Med. Sci., Professor, Deputy Director for Research

Marina B. Albegova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: albegova@yahoo.com
MD, Ph.D., Head of Consultative Pediatric Unit

Anna R. Kirtbaya

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: a_kirtbaya@oparina4.ru
Ph.D., Clinical Care Supervisor at the A.G. Antonov Neonatal Intensive Care Unit, Institute of Neonatology and Pediatrics

Elena A. Filippova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: fla77@mail.ru
Ph.D., Head of the Department of Ultrasound Diagnostics in Neonatology and Pediatrics

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