Long term prognosis of symptomatic occipital lobe epilepsy secondary to neonatal hypoglycemia

Montassir, Hesham; Maegaki, Yoshihiro; Ohno, Kousaku; Ogura, Kyozo

doi:10.1016/j.eplepsyres.2009.10.001

Cited by 23 publications

(18 citation statements)

References 16 publications

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“…Our seizure outcome findings are similar to those of studies from Argentina and Japan in which benign seizure outcome was reported in five out of six and eleven out of 12 children with focal seizures . However, our findings contrast those of studies from India and Turkey in which refractory seizures were reported in twelve out of 23 children with epilepsy and five out of 12 children with focal seizures .…”

Section: Discussionsupporting

confidence: 80%

Variable outcome for epilepsy after neonatal hypoglycaemia

Fong

Harvey

2014

Develop Med Child Neuro

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ABBREVIATION IEDsInterictal epileptiform discharges AIM To evaluate the electroclinical features of epilepsy secondary to neonatal hypoglycaemia.METHOD This was a retrospective study of children who had seizures beyond infancy after neonatal hypoglycaemia treated at The Royal Children's Hospital, Melbourne between 1996 and 2012. Patients with perinatal asphyxia were excluded. Clinical details were obtained from medical records. Digital electroencephalography (EEG) and brain magnetic resonance imaging (MRI) were reviewed. Eleven patients met the inclusion criteria (six males, five females; mean age 10y 5mo, range 4-18y at the time of review).RESULTS Age at seizure onset ranged from 4 months to 5 years. Seizures were focal occipital in nine and generalized tonic in two patients. MRI showed gliosis with or without cortical atrophy in the occipital lobe with or without parietal lobe in all. Predominant EEG findings were stereotyped occipital sharp-slow discharges in five, polymorphic occipital spike-wave or paroxysmal fast activity in three, and generalized slow spike-wave and fast activity in two. Seizures were infrequent or remitted in six of the nine children with focal occipital seizures, and frequent and refractory in both children with generalized seizures.INTERPRETATION Despite the common antecedent and bilateral occipital lobe injury, the seizure manifestations and course of epilepsy after neonatal hypoglycaemia were variable, with mild occipital, refractory occipital, and symptomatic generalized epilepsy recognized.

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Section: Discussionsupporting

confidence: 80%

Variable outcome for epilepsy after neonatal hypoglycaemia

Fong

Harvey

2014

Develop Med Child Neuro

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“…[9] In keeping with this pattern of injury, long-term sequelae have been described in a neurologic syndrome of cortical visual loss, occipital localization-related epilepsy, and psychomotor retardation. [9, 10, 26]…”

Section: Discussionmentioning

confidence: 99%

“…Neonatal hypoglycemia has been associated with adverse outcomes in term infants, resulting in visual impairment,[7] localization-related epilepsy,[8–10] and cognitive deficits. [11–13] Animal and human research suggest that the combination of perinatal hypoxia-ischemia and neonatal hypoglycemia may result in worse outcomes.…”

mentioning

confidence: 99%

Hypoglycemia is Associated with Increased Risk for Brain Injury and Adverse Neurodevelopmental Outcome in Neonates at Risk for Encephalopathy

Tam

Haeusslein

Bonifacio

et al. 2012

The Journal of Pediatrics

136

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Objective To investigate the contribution of hypoglycemia in the first 24 hours after birth to brain injury in term newborns at risk for neonatal encephalopathy. Study design A prospective cohort of 94 term neonates born between 1994 and 2010 with early postnatal brain MRI studies were analyzed for regions of brain injury. Neurodevelopmental outcome was assessed at one year of age. Results Hypoglycemia (glucose <46mg/dL) in the first 24 hours after birth was detected in 16% of the cohort. Adjusting for potential confounders of early perinatal distress and need for resuscitation, neonatal hypoglycemia was associated with a 3.72-fold increased odds of corticospinal tract injury (P=0.047). Hypoglycemia was also associated with 4.82-fold increased odds of one-point worsened neuromotor score (P=0.038) and a 15-point lower cognitive and language score on the Bayley Scales of Infant Development (P=0.015). Conclusion Neonatal hypoglycemia is associated with additional risks in the setting of neonatal encephalopathy with increased corticospinal tract injury and adverse motor and cognitive outcomes.

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“…In infants without hypoglycemia, there was a median of 5 glucose measurements (IQR, [3][4][5][6][7][8][9], and the lowest recorded value occurred an average of 20 hours after birth, or more than 48 hours before MR imaging. Infants with clinical hypoglycemia were tested a median of 11 times (IQR, 7-16), more often than infants without hypoglycemia (P Ͻ .001).…”

Section: Clinical Hypoglycemiamentioning

confidence: 99%

“…7 Neonatal hypoglycemia (Ͻ46 mg/dL) occurs in 5% to 15% of normal term neonates and can cause visual impairment, epilepsy, and cognitive deficits. [9][10][11] Numerous animal and human studies have suggested that neonatal hypoglycemia in the context of HIE may be more detrimental than either condition alone. [12][13][14] These studies also suggest that lower glucose levels are associated with a higher severity of encephalopathy and a worse outcome at 2 years.…”

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confidence: 99%