Epileptology, Sleep Disorders and Functional Pediatric Neurology, Member of ERN-EpiCARE; HFME, Hospices Civils de Lyon, 59 Boulevard Pinel, Bron, France.
Epileptology, Sleep Disorders and Functional Pediatric Neurology, Member of ERN-EpiCARE; HFME, Hospices Civils de Lyon, 59 Boulevard Pinel, Bron, France.
Eur J Paediatr Neurol. 2019 Mar;23(2):270-279. doi: 10.1016/j.ejpn.2019.01.006. Epub 2019 Jan 29.
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.
评估新生儿癫痫持续状态（SE）的预测因素，以及患有孤立性发作或 SE 的新生儿患者结局的预后因素。
这是一项回顾性单中心研究，时间从 2010 年 1 月至 2014 年 12 月，共纳入 91 例新生儿癫痫发作患儿。其中，50 例新生儿发生 SE，41 例新生儿仅表现为孤立性发作。SE 定义为单次发作持续时间超过 15 分钟或无发作性神经功能恢复超过 15 分钟的反复发作。孤立性发作定义为单次发作持续时间小于 15 分钟或多次发作之间意识完全恢复。记录围产期和电临床数据。在 1 年的随访中评估结局。
在多变量分析中，被确定为 SE 预测因素的因素是初始神经检查严重异常（OR 15.7，95%CI（3.8-109），p=0.00075）和低血糖（OR 6.8，95%CI（1.5-49.2），p=0.024），这些因素主要见于伴有缺氧缺血性脑病的新生儿。当研究我们的整体队列时，SE 在单变量分析中仅被发现是结局的负预后因素。在仅有孤立性发作的新生儿中，发作后临床检查结果是唯一发现的独立预后因素，正常结果与更有利的结局相关（OR 48.9，95%CI（7.16-571），p=0.0003）。
已经确定了新生儿 SE 的两个独立危险因素：初始神经检查严重异常和低血糖。在仅有孤立性发作的新生儿中，唯一的阳性预后因素是发作后临床检查正常。
