Incidence of Epilepsy after Neonatal Seizures: A Population-Based Study

Andreolli, Anna; Turco, Emanuela Claudia; Pedrazzi, Giuseppe; Beghi, Ettore; Pisani, Francesco

doi:10.1159/000494702

Cited by 18 publications

(12 citation statements)

References 48 publications

(40 reference statements)

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“…However, the prevalence of long-term neurological sequelae in survivors remains unchanged at 30%. 1,11 The incidence of postneonatal epilepsy, 134 cerebral palsy, and developmental delay is higher in preterm neonates, 8,135 with a reported odds ratio of 14 (95% confidence interval [CI]: 2-86) per week of gestational age. 136 This shift from mortality to morbidity in the preterms poses a significant challenge for clinical management in the NICU.…”

Section: Outcome Of Neonatal Seizuresmentioning

confidence: 99%

Neonatal Seizures—Are We there Yet?

et al. 2019

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Neonatal seizures are the most prevalent and distinctive sign of neurologic dysfunction in early life and pose an immense challenge for clinicians. Improvements in neonatal care have increased the survival rate of extremely premature infants, considerably changing the spectrum of underlying etiologies, and instigating a gradual shift from mortality to morbidity. Recognizing neonatal seizures can be challenging due to variability in presentation but clinical features can often provide valuable clues about etiology. Yet, the majority of neonatal seizures are subclinical. Even though conventional electroencephalography (EEG) with simultaneous video detection of seizures still represents the diagnostic gold standard, continuous monitoring using a one- to two-channel amplitude-integrated EEG with concurrent unprocessed EEG can be crucial for early recognition and intervention. Furthermore, tremendous progress has been made in neuroimaging, and all infants with seizures should have a magnetic resonance imaging (MRI) to help identify the underlying etiology. While the majority of neonatal seizures are caused by hypoxic-ischemic events, stroke, hemorrhage, or infection, approximately 15% of patients will require more sophisticated algorithms for diagnostic workup, including metabolic and genetic screening. These recent developments have led to renew interest in the classification of neonatal seizures, which aim to help identify etiology and guide appropriate therapeutic and prognostic decisions. In this review, we outline recent progress made in the etiology, diagnosis, and treatment of neonatal seizures and highlight areas that deserve further research.

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Section: Outcome Of Neonatal Seizuresmentioning

confidence: 99%

Neonatal Seizures—Are We there Yet?

et al. 2019

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“…A recent population-based study 20 enrolled all neonates with the history of NS who developed epilepsy by the time of the study in Italy. The epilepsy incidence measured by the authors was of 15.2%.…”

Section: Discussionmentioning

confidence: 99%

Neonatal Seizure and Afterward, Epilepsy: A Systematic Review

Zafari

Pajouhandeh

Ahmadi

2019

Int Clin Neurosci J

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Background: The purpose of the current study is to estimate the incidence of epilepsy after neonatal seizure (NS) by reviewing of the latest studies on the relationship between NSs and epilepsy in newborns and also discuss risk factors may contribute to this relationship. Methods: A literature review was performed using the search terms "neonatal seizure AND epilepsy," "newborns AND epilepsy," "postneonatal epilepsy." After exclusion of several studies, which did not meet inclusion criteria, the epilepsy incidence rate was measured by dividing the number of all cases of epilepsy who had a history of NS in selected studies considered with the number of all newborns enrolled to the studies minus the number of cases who lost the follow-ups. Results: By reviewing the literature, 13 studies were found, which completely meet the inclusion criteria and published between 2009 and 2019, of which three were population-based while the remaining studies performed hospital-based. Overall, the population evaluated in these series has been estimated to be 2438 newborns of which 454 died, and 300 missed the follow-ups. The incidence rate for afterward epilepsy in all 1684 subjects with NS was 20%, literally 343 of the NS subjects. Conclusion: The presented review enrolled the most recent studies encompassing enough and extended the time as well as adequate sample size. Epilepsy is considered a common outcome of NS, particularly in those with other neurodevelopmental comorbidities, even if there were always several limits associated with various study designs and condition.

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“…However, this temporal distinction between acute and remote seizures in neonates is particularly challenging, as structural or metabolic neonatal epilepsies can also present with a seizure onset in the first week of life. It should be noted that, although neonates with acute brain injury have an increased risk of developing post-neonatal epilepsy due to secondary epileptogenesis [48,49], by definition acute symptomatic seizures are unlikely to recur, unless the underlying acute causal condition recurs [50].…”

Section: Acute Symptomatic Seizuresmentioning

confidence: 99%

“…Acute symptomatic seizures initially stopping within a few days or weeks, but eventually evolving after a latent period of variable duration in post-neonatal epilepsy. About 18-33 % of survivors from neonatal seizures present unprovoked, remote symptomatic seizures, most of them within the first year of life [48,49,78,79]. Usually, unprovoked epileptic seizures in these children coincide with other significant disabilities such as cerebral palsy and cognitive impairment [19,80].…”

Section: Clinical Scenarios In the Neonatal Periodmentioning

confidence: 99%

Seizures in the neonate: A review of etiologies and outcomes

Pisani

Spagnoli

Falsaperla

et al. 2021

Seizure

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Neonatal seizures occur in their majority in close temporal relation to an acute brain injury or systemic insult, and are accordingly defined as acute symptomatic or provoked seizures. However less frequently, unprovoked seizures may also present in the neonatal period as secondary to structural brain abnormalities, thus corresponding to structural epilepsies, or to genetic conditions, thus corresponding to genetic epilepsies. Unprovoked neonatal seizures should be thus considered as the clinical manifestation of early onset structural or genetic epilepsies that often have the characteristics of early onset epileptic encephalopathies. In this review, we address the conundrum of neonatal seizures including acute symptomatic, remote symptomatic, provoked, and unprovoked seizures, evolving to post-neonatal epilepsies, and neonatal onset epilepsies. The different clinical scenarios involving neonatal seizures, each with their distinct post-neonatal evolution are presented. The structural and functional impact of neonatal seizures on brain development and the concept of secondary epileptogenesis, with or without a following latent period after the acute seizures, are addressed. Finally, we underline the need for an early differential diagnosis between an acute symptomatic seizure and an unprovoked seizure, since it is associated with fundamental differences in clinical evolution. These are crucial aspects for neonatal management, counselling and prognostication. In view of the above aspects, we provide an outlook on future strategies and potential lines of research in this field.

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Incidence of Epilepsy after Neonatal Seizures: A Population-Based Study

Cited by 18 publications

References 48 publications

Neonatal Seizures—Are We there Yet?

Neonatal Seizures—Are We there Yet?

Neonatal Seizure and Afterward, Epilepsy: A Systematic Review

Seizures in the neonate: A review of etiologies and outcomes

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