Seizures are the most common neurological emergency in the neonatal period and in contrast to those in infancy and childhood, are often provoked seizures with an acute cause and may be electrographic‐only. Hence, neonatal seizures may not fit easily into classification schemes for seizures and epilepsies primarily developed for older children and adults. A Neonatal Seizures Task Force was established by the International League Against Epilepsy (ILAE) to develop a modification of the 2017 ILAE Classification of Seizures and Epilepsies, relevant to neonates. The neonatal classification framework emphasizes the role of electroencephalography (EEG) in the diagnosis of seizures in the neonate and includes a classification of seizure types relevant to this age group. The seizure type is determined by the predominant clinical feature. Many neonatal seizures are electrographic‐only with no evident clinical features; therefore, these are included in the proposed classification. Clinical events without an EEG correlate are not included. Because seizures in the neonatal period have been shown to have a focal onset, a division into focal and generalized is unnecessary. Seizures can have a motor (automatisms, clonic, epileptic spasms, myoclonic, tonic), non‐motor (autonomic, behavior arrest), or sequential presentation. The classification allows the user to choose the level of detail when classifying seizures in this age group.
The development of diagnostic techniques that confirm a cause-effect association and studies regarding the physiopathology of the central nervous system impairment should be prioritized. It is also necessary to strictly define the criteria for the diagnosis of microcephaly to identify cases that should undergo an etiological investigation.
-Objective: To evaluate the influence of gestational age and birth weight on language development and neurodevelopmental outcome at age 3 years in children born preterm. Method: Cross sectional study including 69 children followed in our developmental outpatient clinic. Patients were consecutively included at the time of the 3 years of age appointment and stratified for birth weight (<1500 grams and between 1500-2500 grams). All patients were assessed for receptive and expressive language , Denver II and Bayley II tests and clinical neurological examination. For analysis patients were divided in two gro u p s n o rmal language acquisition (NLA) and delay in language acquisition (DLA). Results: NLA children had higher scores on mental and psychomotor (p=<0.01, p=0.012) indexes of Bayley II. Newborns with less than 1500 grams had lower scores on all Bayley scale at age 36 months (p=0.002, p=0.007 and p<0.001). Multivariate analysis suggests an association between gestational age (p=0.032), abnormal behavior (p<0.001) and delay in language acquisition. Denver test at 12 and 24 months of age was a good pre d i ctor of delayed receptive and expressive language at three years of age (p=<0.01 and p=<0.01). C o n c l u s i o n : C h i l d ren born pre m a t u rely with low birth weight had an increased risk of language acquisition delay, and those had also lower cognitive and behavior scores when compared to NLA.KEY WORDS: p re m a t u r i t y, low birth weight, language acquisition, developmental delay, Bayley infant scale, Denver test. Avaliação da evolução dos aspectos linguísticos em crianças que nasceram prematuras aos 3 anos de idadeRESUMO -Objetivo: Avaliar influência da idade gestacional (IG) e peso ao nascimento na aquisição da linguagem e neurodesenvolvimento em crianças de 3 anos que nasceram pre m a t u r a s . Método: Estudo transversal incluindo 69 crianças acompanhadas no Ambulatório de Seguimento Neonatal. Pacientes incluídos tinham 3 anos e foram estratificados por peso ao nascimento (>1500 gramas e entre 1500-2500 gramas). Todos foram avaliados com relação ao neurodesenvolvimento incluindo avaliação neurológica clínica, Denver II, Bayley II e avaliação da linguagem. Para a analise dividimos em dois grupos com e sem alteração na aquisição de linguagem. Resultados: Crianças com DAL apresentam melhores índices nos escores de desenvolvimento no Bayley II (p=<0.01 e p=0.012). Crianças que nasceram com peso >1500 gramas tiveram escores menores no Bayley II na idade de 36 m (p=0.002, p=0.007 e p<0.001). Análise multivariada sugere uma associação da IG (p=0,032) e alteração comportamental (p=0,001) com atraso na aquisição da linguagem. Denver II alterado tanto aos 12 m quanto aos 24 m, correlaciona-se com significância estatística a atraso na aquisição de linguagem receptiva e expressiva aos 3 anos de idade (p=<0.01 e p=<0.01). Conclusão: Crianças nascidas prematuras e com baixo peso ao nascimento, apresentam maior risco de ter um atraso no desenvolvimento da linguagem. Sendo que as crianças que tem a...
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