Article

AIM: To examine the relationship between electrographic seizures and long-term
outcome in neonates with hypoxic-ischemic encephalopathy (HIE). METHOD: Full-term
neonates with HIE born in Cork University Maternity Hospital from 2003 to 2006
(pre-hypothermia era) and 2009 to 2012 (hypothermia era) were included in this
observational study.
All had early continuous electroencephalography monitoring.
All electrographic seizures were annotated. The total seizure burden and hourly
seizure burden were calculated. Outcome (normal/abnormal) was assessed at 24 to
48 months in surviving neonates using either the Bayley Scales of Infant and
Toddler Development, Third Edition or the Griffiths Mental Development Scales; a
diagnosis of cerebral palsy or epilepsy was also considered an abnormal outcome.
RESULTS: Continuous electroencephalography was recorded for a median of 57.1
hours (interquartile range 33.5-80.5h) in 47 neonates (31 males, 16 females); 29
out of 47 (62%) had electrographic seizures and 25 out of 47 (53%) had an
abnormal outcome. The presence of seizures per se was not associated with
abnormal outcome (p=0.126); however, the odds of an abnormal outcome increased
over ninefold (odds ratio [OR] 9.56; 95% confidence interval [95% CI] 2.43-37.67)
if a neonate had a total seizure burden of more than 40 minutes (p=0.001), and
eightfold (OR: 8.00; 95% CI: 2.06-31.07) if a neonate had a maximum hourly
seizure burden of more than 13 minutes per hour (p=0.003). Controlling for
electrographic HIE grade or treatment with hypothermia did not change the
direction of the relationship between seizure burden and outcome. INTERPRETATION:
In HIE, a high electrographic seizure burden is significantly associated with
abnormal outcome, independent of HIE severity or treatment with hypothermia.
CI - (c) 2016 The Authors. Developmental Medicine & Child Neurology published by John
Wiley & Sons Ltd on behalf of Mac Keith Press.

Langue : ANGLAIS