Department of Pediatrics, Division of Child Neurology, Ege University Medical Faculty, Turkey.
Department of Pediatrics, Division of Neonatology, Ege University Medical Faculty, Turkey.
Seizure. 2024 Mar;116:133-139. doi: 10.1016/j.seizure.2022.12.007. Epub 2022 Dec 29.
To assess the impact of clinical neonatal seizures on outcome characteristics of preterm and term newborns with neonatal encephalopathy (NE).
We designed a prospective comparative study with 53 babies (preterm neonates: 26 and term neonates: 27) with NE: group 1 (preterm neonates with seizures, n = 13), group 2 (preterm neonates without seizures, n = 13), group 3 (term neonates with seizures, n = 13) and group 4 (term neonates without seizures, n = 14). The functional outcome characteristics of the survivors were assessed by the Ankara Developmental Screening Inventory (ADSI) and the Guide for Monitoring Child Development (GMCD) at 12 months of age.
Clinically defined acute symptomatic seizures were diagnosed with prompt conventional EEG / amplitude-integrated EEG in preterm (92.3%) and term neonates (81.4%) with etiology-specific diagnoses of NE. There were no differences between the study groups regarding seizure semiology and EEG characteristics. A primary adverse outcome was defined in 22 (41.5%) of the cohort. However, only 15.3% of infants had an unfavorable functional outcome with ADSI at 12 months. Among the survivors, there was no significant difference between the study groups regarding ADSI scores. The GMDC test revealed normal development in 50% of survivors with seizures in the preterm group and 83% in the term group.
There was no significant difference between the characteristics of functional outcomes at 12 months in preterm and term neonates with NE for clinical seizures.
评估新生儿脑病（NE）早产儿和足月儿临床惊厥对结局特征的影响。
我们设计了一项前瞻性对比研究，共纳入 53 名 NE 患儿（早产儿：26 例，足月儿：27 例）：组 1（有惊厥的早产儿，n=13），组 2（无惊厥的早产儿，n=13），组 3（有惊厥的足月儿，n=13）和组 4（无惊厥的足月儿，n=14）。通过 Ankara 发育筛查量表（ADSI）和儿童发育监测指南（GMCD）在 12 月龄评估幸存者的功能结局特征。
根据病因特异性诊断为 NE 的早产儿（92.3%）和足月儿（81.4%），通过即时常规脑电图/振幅整合脑电图诊断出临床定义的急性症状性惊厥。研究组之间的惊厥症状学和脑电图特征无差异。共有 22 例（41.5%）患儿出现原发性不良结局。然而，仅有 15.3%的患儿在 12 月龄时 ADSI 评估为功能结局不良。在幸存者中，ADSI 评分在研究组之间无显著差异。GMDC 测试显示，在有惊厥的早产儿组中，50%的幸存者发育正常，在足月儿组中，83%的幸存者发育正常。
在 NE 早产儿和足月儿中，临床惊厥对 12 月龄时的功能结局特征无显著差异。
