Nunes Magda Lahorgue, Martins Maurer Pereira, Barea Bianca Menke, Wainberg Ricardo C, Costa Jaderson Costa da
Neurodevelopment Outpatient Clinic, Hospital São Lucas, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Arq Neuropsiquiatr. 2008 Jun;66(2A):168-74. doi: 10.1590/s0004-282x2008000200005.
To describe the neurological outcome of newborns with seizures.
Cohort study with newborns prospectively followed. Perinatal characteristics and etiological screening were related to outcome in a regression model.
During the study 3,659 newborns were admitted and 2.7% were diagnosed as having seizures. Hypoxic ischemic encephalopathy (51%) was the etiology more frequently associated to seizures and also to postneonatal epilepsy (53%). In the follow up 25 died during the acute neonatal illness and 9 during the first years of life, 19 were diagnosed as having post neonatal epilepsy, 35 had developmental delay and 11 an association among this two comorbidities. A significant association between abnormal postnatal EEG and neuroimaging to developmental delay (p=0.014, p=0.026) was observed. The group of newborns that had seizures presented an increased risk of developing epilepsy compared to newborns from the same cohort without seizures (19.3/100 vs. 1.8/100, p<0.001).
In this study neonatal seizures predominated in term newborns with perinatal asphyxia an elevated perinatal mortality and post neonatal morbidity was observed. The follow up showed an increased risk for developing postnatal epilepsy and developmental delay.
描述癫痫新生儿的神经学转归。
对新生儿进行前瞻性队列研究。在回归模型中，围产期特征和病因筛查与转归相关。
在研究期间，共收治3659例新生儿，其中2.7%被诊断为癫痫。缺氧缺血性脑病（51%）是与癫痫以及新生儿期后癫痫（53%）最常相关的病因。在随访中，25例在新生儿急性疾病期间死亡，9例在生命的头几年死亡，19例被诊断为新生儿期后癫痫，35例有发育迟缓，11例同时存在这两种合并症。观察到出生后脑电图异常和神经影像学与发育迟缓之间存在显著关联（p = 0.014，p = 0.026）。与同一队列中无癫痫的新生儿相比，有癫痫的新生儿发生癫痫的风险增加（19.3/100对1.8/100，p<0.001）。
在本研究中，足月围产期窒息新生儿中癫痫发作占主导，观察到围产期死亡率升高和新生儿期后发病率升高。随访显示出生后癫痫和发育迟缓的发生风险增加。
