Clinical Neonatal Seizures are Independently Associated with Outcome in Infants at Risk for Hypoxic-Ischemic Brain Injury - 09/08/11
, David Glidden, PhD c, Rita J. Jeremy, PhD b, A. James Barkovich, MD a, b, d, Donna M. Ferriero, MD a, b, Steven P. Miller, MDCM a, e
Reprint requests: Hannah C. Glass, University of California San Francisco, Department of Neurology, Box 0663, 521 Parnassus Avenue, C-215, San Francisco, CA 94143-0663.Abstract |
Objective |
To examine whether neonatal seizures are associated with neurodevelopmental outcomes in infants with hypoxia-ischemia independent of the presence and severity of brain injury seen on magnetic resonance imaging (MRI).
Study design |
We used multivariate regression to examine the independent effect of clinical neonatal seizures and their treatment on neurodevelopment in 77 term newborns at risk for hypoxic-ischemic brain injury. Clinical seizures were recorded prospectively, and high-resolution newborn MRI measured the severity of brain injury. The outcome measure was the Full-Scale Intelligence Quotient (FSIQ) of the Wechsler Preschool and Primary Scale of Intelligence-Revised and neuromotor score at age 4 years.
Results |
After controlling for severity of injury on MRI, the children with neonatal seizures had worse motor and cognitive outcomes compared with those without seizures. The magnitude of effect varied with seizure severity; children with severe seizures had a lower FSIQ than those with mild/moderate seizures (P < .0001).
Conclusions |
Clinical neonatal seizures in the setting of birth asphyxia are associated with worse neurodevelopmental outcome, independent of the severity of hypoxic-ischemic brain injury. Randomized controlled trials are needed to determine whether differences in seizure treatment can improve outcome.
Le texte complet de cet article est disponible en PDF.Mots-clés : CI, EEG, FSIQ, MRI, SD, SE, WPPSI-R
Plan
| Supported by Grant UL RR024131-01 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH); the NIH Roadmap for Medical Research; and NIH Grant NS40117. H. G. is supported by National Institute of Neurological Disorders and Stroke Neurological Sciences Academic Development Award NS01692. The contents are solely the responsibility of the authors and do not necessarily represent the official view of the NCRR or the NIH. S.M. is supported by a Clinician Scientist award from the Canadian Institutes of Health Research and a Scholar award from the Michael Smith Foundation for Health Research. The authors report no conflicts of interest. |
Vol 155 - N° 3
P. 318-323 - septembre 2009 Retour au numéro
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