Long-term prognosis in children with neonatal seizures

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Abstract
Objective: To examine outcome and explore for prognostic markers in a cohort p = 0.003): term: 28 (45%) normal, 10 (16%) deaths, and 24 (39%) with impairments; preterm: 3 (12%) normal, 11 (42%) deaths, and 12 (46%) with impairments. Of survivors, 17 (27%) developed epilepsy, 16 (25%) had cerebral palsy, 13 (20%) had mental retardation, and 17 (27%) had learning disorders. Variables associated with poor prognosis were Sarnat stage III or equivalent severe encephalopathy, cerebral dysgenesis, complicated intraventricular hemorrhage, infections in the preterm infants, abnormal neonatal EEGs, and the need for multiple drugs to treat the neonatal seizures. Pure clonic seizures without facial involvement in term infants suggested favorable outcome, whereas generalized myoclonic seizures in preterm infants were associated with mortality. Conclusions: Poor prognosis for premature infants with seizures is reflected in high rates of subsequent long-term disability and mortality. The severity and timing of the pathologic process continue to be the major determinants for outcome. GLOSSARY: AED = antiepileptic drug; BW = birth weight; CLNESZ = clinical neonatal seizures; CP = cerebral palsy; GA = gestational age; IVH = intraventricular hemorrhage; LD = learning disability; MR = mental retardation; NCPP = National Collaborative Perinatal Project; NICU = neonatal intensive care unit.

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