The effect of hypotension on brain energy state during prolonged neonatal seizure.

Prolonged seizures in the human neonate may be complicated by systemic hypotension. To examine the effect of systemic hypotension on brain metabolic state during seizure, neonatal dogs were made hypotensive (by exsanguination) during bicuculline-induced seizure. Measurement of regional cerebral blood flow showed that moderate hypotension did not impair cerebral perfusion during seizure. Measurement of brain energy state with in vivo 31P nuclear magnetic resonance spectroscopy disclosed a similar pattern of alteration of high energy phosphates in animals subjected to seizure or to the combination of seizure and hypotension. The additional metabolic stress imposed by moderate hypotension during seizure in the neonatal dog appears to be slight.