Predictive factors and prognostic value for status epilepticus in newborns

To evaluate the predictive factors for status epilepticus (SE) in neonates and prognostic factors for patient outcomes in newborns suffering either isolated seizures or SE. A retrospective single-center study from January 2010 to December 2014, included 91 newborns who had neonatal seizures. Among t...

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Bibliographic Details
Published in:European journal of paediatric neurology 2019-03, Vol.23 (2), p.270-279
Main Authors: Gokce-Samar, Zeynep, Ostrowsky-Coste, Karine, Gauthier-Morel, Dominique, Keo-Kosal, Pascale, De Regnauld De Bellescize, Julitta, Montavont, Alexandra, Panagiotakaki, Eleni, Claris, Olivier, Arzimanoglou, Alexis
Format: Article
Language:English
Subjects:
Cohort Studies
Electroencephalography
Female
Humans
Hypoglycemia
Hypoglycemia - complications
Hypoxia-Ischemia, Brain - complications
Hypoxic-ischemic encephalopathy
Infant, Newborn
Infant, Newborn, Diseases
Life Sciences
Male
Multivariate Analysis
Neonatal isolated seizures
Neonatal status epilepticus
Neurologic Examination
Neurological examination
Outcome
Prognosis
Retrospective Studies
Risk Factors
Seizures - complications
Status Epilepticus - complications
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Summary:To evaluate the predictive factors for status epilepticus (SE) in neonates and prognostic factors for patient outcomes in newborns suffering either isolated seizures or SE. A retrospective single-center study from January 2010 to December 2014, included 91 newborns who had neonatal seizures. Among them, 50 newborns experienced SE and 41 newborns presented isolated seizures only. SE was defined as a single seizure lasting more than 15 min or repeated seizures without return to preictal neurological baseline for more than 15 min. Isolated seizures were defined as one single seizure lasting less than 15 min or more seizures with complete recovery of consciousness between seizures. Perinatal and electroclinical data were recorded. Outcomes were evaluated at one year follow up. In multivariate analysis, the factors identified as being predictive of SE were a severely abnormal initial neurological examination (OR 15.7, 95% CI (3.8–109) p = 0.00075) and hypoglycaemia (OR 6.8, 95% CI (1.5–49.2) p = 0.024), found mostly in newborns with hypoxic-ischemic encephalopathy. When studying our global cohort, SE was found to be a negative prognostic factor for outcome only in univariate analysis. In newborns with isolated seizures only, the postictal clinical examination results were the only independent prognostic factor found, normal results being associated with a more favorable evolution (OR 48.9, 95% CI (7.16–571) p = 0.0003). Two independent risk factors for SE in newborns have been identified: a severely abnormal initial neurological examination and hypoglycaemia. In newborns with isolated seizures, the only positive prognostic factor was found to be a normal postictal clinical examination. •A severely abnormal neurological examination at onset is a risk factor for SE in newborns.•Hypoglycemia at onset is also a predictive factor for SE in newborns.•In newborns with SE, a normal postictal clinical examination is associated with a favourable outcome in univariate analysis.•In newborns with isolated seizures, a normal postictal clinical examination is associated with a favourable outcome.
ISSN:1090-3798
1532-2130
DOI:10.1016/j.ejpn.2019.01.006