Incidence of neonatal seizures, perinatal risk factors for epilepsy and mortality after neonatal seizures in the province of Parma, Italy

Pisani, Francesco; Facini, Carlotta; Bianchi, Elisa; Giussani, Giorgia; Piccolo, Benedetta; Beghi, Ettore

doi:10.1111/epi.14537

Cited by 59 publications

(60 citation statements)

References 29 publications

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“…The occurrence of neonatal seizures is a risk factor for cerebral palsy [8][9][10]. Neonatal seizures can be a strong predictor for epilepsy in cerebral palsy [7,11,12] .…”

Section: Introductionmentioning

confidence: 99%

Hemiplegic (unilateral) cerebral palsy in northern Stockholm: clinical assessment, brain imaging, EEG, epilepsy and aetiologic background factors

Tillberg

Isberg²,

Persson

2020

BMC Pediatr

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Background: The purpose of this study was to describe clinical presentation, epilepsy, EEG, extent and site of the underlying cerebral lesion with special reference towards aetiologic background factors in a population-based group of children with hemiplegic cerebral palsy. Methods: Forty-seven children of school-age, fulfilling the SPCE (Surveillance of Cerebral palsy in Europe)-criteria of hemiplegic cerebral palsy, identified via the Swedish cerebral palsy register, were invited and asked to participate in the study. Results: Fifteen boys and six girls participated. Of the sixteen children born at term, five had no risk factors for cerebral palsy. Two out of five preterm children presented additional risk factors. Debut of motor impairment was observed in the first year of life in sixteen children. Age at diagnosis varied from 2 months to 6 years. Epilepsy was common and associated with grey-and white matter injury. Conclusions: Recognizing the importance of risk factors for cerebral palsy, any child with these risk factors should be offered a checkup by a paediatrician or a paediatric neurologist. Thereby reducing diagnostic delay. Epilepsy is common in hemiplegic cerebral palsy and associated with grey-and white matter injury in this cohort.

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“…The occurrence of neonatal seizures is a risk factor for cerebral palsy [8][9][10]. Neonatal seizures can be a strong predictor for epilepsy in cerebral palsy [7,11,12] .…”

Section: Introductionmentioning

confidence: 99%

Hemiplegic (unilateral) cerebral palsy in northern Stockholm: clinical assessment, brain imaging, EEG, epilepsy and aetiologic background factors

Tillberg

Isberg²,

Persson

2020

BMC Pediatr

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“…By December 2016, 17 patients (5 males and 12 females) developed epilepsy, 13 (76.5%) having a structural etiology and 4 (23.5%) inherited metabolic disorders [10], resulting in a 15.2% incidence (95% CI 9.7-23.0). The incidence was 8.2% for male (95% CI 3.6-17.8%) and 23.5% for female (95% CI 14.0-36.8%; p = 0.047).…”

Section: Epilepsy After Nsmentioning

confidence: 99%

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

et al. 2019

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Background: The incidence of childhood and adolescence epilepsy varies in different areas and over time. Published reports in the Italian pediatric population are few and there is no information on the incidence of epilepsy using the new clinical definition of the disease signed by the International League Against Epilepsy. An increased risk of epilepsy is reported in subjects who presented with neonatal seizures (NS), but few population-based studies are available that compare incidence and age at onset of epilepsy in children with and without NS. Objectives: Ascertain the incidence of epilepsy in children in the province of Parma by applying the new practical clinical definition of epilepsy, and compare incidence and age of epilepsy onset in children with and without previous NS. Methods: The study was carried out in the province of Parma, Emilia-Romagna Region, Northern Italy, using different data sources (clinical records and administrative data), and considered all the children born in the province of Parma between January 2002 and December 2014 and developing epilepsy by December 2016. We calculated the incidence of epilepsy in patients up to 14 years of age, incidence of epilepsy after NS and cumulative incidence of epilepsy at 1, 5, and 10 years’ follow-up. To evaluate age at onset of epilepsy, we divided patients into 3 groups (epilepsy onset within 1 month, between 1 and 12 months, and after 1 year of life) and we compared age at onset of epilepsy between patients who had had previous NS and those who had not. Results: The incidence of epilepsy was 78.6/100,000 persons-years (boys 88.1/100,000, girls 68.6/100,000). The incidence of epilepsy after NS was 15.2% (8.2% for male, 23.5% for female; 16.3% in born at term, 14.3% in pre-term). The incidence of epilepsy at 1, 5, and 10 years’ follow-up was higher in patients with previous NS than in others. The age at onset of epilepsy was significantly different in the 2 groups, and was younger in those with history of NS: mean age at onset was 10.5 months in those with NS and of 61.8 months in the others. Conclusions: The incidence rate of epilepsy in the Parma district was higher than that reported in other Italian areas studied, probably due to the different methodology used and the application of the most recent definition of epilepsy. Children with NS were at higher risk of epilepsy and develop the disease at a younger age.

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“…Seizures are one of the most common presentations of neurologic disease in the neonate, with an incidence estimated between 0.95 and 2.29 per 1,000 live births. [1][2][3][4] The majority present within the first 48 hours of life. 3,4 In contrast to seizures occurring later in infancy or early childhood, neonatal seizures are often symptomatic and present in the setting of acute illness.…”

mentioning

confidence: 99%

“…Reported etiologies determined through large case series include hypoxic-ischemic encephalopathy (HIE, 28-50%), intracranial hemorrhage (11-26%), metabolic derangement (16-19%), ischemic stroke (18%), congenital brain malformation (1.2-10%), and inborn errors of metabolism (IEM, up to 3%). 2,3,5,6 Neonatal seizures are associated with long-term neurologic sequelae with increased risks for epilepsy, cerebral palsy, intellectual disability, and/or learning disability. [6][7][8] Neonates with seizures due to an IEM may have poorer outcomes, including higher risk for mortality.…”

mentioning

confidence: 99%

“…[6][7][8] Neonates with seizures due to an IEM may have poorer outcomes, including higher risk for mortality. 2 Early detection of these disorders is critical to allow for prompt initiation of targeted therapies and improved outcomes. Only a subset is identified through newborn screening programs; therefore, targeted work-up is warranted when there is suspicion for an IEM.…”

mentioning

confidence: 99%

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Metabolic Disorders Presenting with Seizures in the Neonatal Period

Brimble

Ruzhnikov

2020

Semin Neurol

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Metabolic disorders represent rare but often treatable causes of seizures and epilepsy of neonatal onset. As seizures are relatively common in the neonatal period, systemic clues to a specific diagnosis may be lacking or shrouded by acute illness. An important role of the consulting pediatric neurologist is to identify neonates with a possible metabolic or otherwise genetic diagnosis. In this review, the authors describe presenting signs and symptoms, a diagnostic framework, and disorder-specific treatment options for inborn errors of metabolism that may present in the neonatal period. Specific attention is given to the neurologic aspects of each condition, including the electroclinical phenotype and findings on brain imaging. As expedited diagnosis and prompt initiation of available therapies have been demonstrated to result in improved epilepsy and developmental outcomes, this work acts as a framework to guide evaluation when an inherited metabolic disorder is suspected. In addition to informing treatment, a definitive diagnosis allows for appropriate counseling regarding prognosis, any associated screening or preventive measures, and family planning.

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Incidence of neonatal seizures, perinatal risk factors for epilepsy and mortality after neonatal seizures in the province of Parma, Italy

Abstract: The incidence of NS is inversely associated with gestational age and birth weight. The etiology and a low Apgar score are strongly related to mortality; female gender and status epilepticus are risk factors for the development of epilepsy.

Cited by 59 publications

References 29 publications

Hemiplegic (unilateral) cerebral palsy in northern Stockholm: clinical assessment, brain imaging, EEG, epilepsy and aetiologic background factors

Hemiplegic (unilateral) cerebral palsy in northern Stockholm: clinical assessment, brain imaging, EEG, epilepsy and aetiologic background factors

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

Metabolic Disorders Presenting with Seizures in the Neonatal Period

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