Magnetic Resonance Imaging and Ultrasound Injury in Preterm Infants With Seizures

Glass, Hannah C.; Bonifacio, Sonia L.; Sullivan, Joseph; Rogers, Elizabeth E.; Ferriero, Donna M.; Goldstein, Ruth B.; Barkovich, A. James

doi:10.1177/0883073809338328

Cited by 24 publications

(13 citation statements)

References 27 publications

(55 reference statements)

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“…Glass et al . [15] in their study reported that 3.8% preterm neonates had clinical seizures. The cranial ultra sound was abnormal in all these infants and was accurate for detecting IVH.…”

Section: Discussionmentioning

confidence: 99%

A study of neurosonogram abnormalities, clinical correlation with neurosonogram findings, and immediate outcome of high-risk neonates in Neonatal Intensive Care Unit

et al. 2016

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Background:Neonatal sonography of the brain is now an essential part of newborn care, particularly in high risk and unstable premature infants. Cranial ultrasound is the most available and easily repeatable imaging technique for the neonatal brain showing brain development and the most frequently occurring forms of cerebral injury in the preterm and terms. This study aims to assess the importance of cranial ultrasound as an investigatory modality for high-risk neonates and to find out the morphology of various cerebral lesions and correlate clinically.Methodology:An observational correlation clinical study was conducted at Sardar Patel Medical College, Bikaner involving 100 high-risk neonates admitted to Neonatal Intensive Care Unit (NICU) who was subjected to neurosonography on selected days as per protocol. Perinatal details were recorded, and clinical examination with appropriate investigations was done. The cranial ultrasound was done, and morphology of various findings was studied and recorded. Clinical correlation with cranial ultrasound findings and follow-up was done.Results:On cranial ultrasound, 38% of neonates had abnormal findings. Twelve percent of these had evidence of intracranial bleed, 13% periventricular echogenicity, 7% had ventriculomegaly, 2% had cerebral edema, and 1% had leukomalacia. Three neonates had findings suggestive of simple cyst in middle cranial fossa, agenesis of corpus callosum, and choroid plexus cyst.Conclusions:Cranial ultrasonography is the best point of care neuroimaging method available for high-risk neonates. It is critical as an investigatory modality in NICU and effectively documents morphology of cerebral damage.

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“…Glass et al . [15] in their study reported that 3.8% preterm neonates had clinical seizures. The cranial ultra sound was abnormal in all these infants and was accurate for detecting IVH.…”

Section: Discussionmentioning

confidence: 99%

A study of neurosonogram abnormalities, clinical correlation with neurosonogram findings, and immediate outcome of high-risk neonates in Neonatal Intensive Care Unit

et al. 2016

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“…When compared with HUS, MRI has much higher resolution for parenchymal injury (32-35), and, as such, is more likely to detect injury associated with seizures in both preterm and term neonates. In one small study of preterm neonates with seizures, MRI provided information that could be useful to guide management or parent counseling (36). Transport and imaging using MRI is safe for preterm neonates, though it requires expertise both in neonatal transport and MR interpretation (37).…”

Section: Discussionmentioning

confidence: 99%

Neonatal Seizures: Treatment Practices Among Term and Preterm Infants

Glass

Kan

Bonifacio

et al. 2012

Pediatric Neurology

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117

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Neonatal seizures are common clinical conditions in both term and preterm neonates, yet there are no clinical management guidelines to direct care. We surveyed 193 international neurologists and neonatologists to assess management practices seizures in preterm and term neonates among neurologists, neonatologists, and specialists in neonatal neurology or neonatal neurocritical care. We found high reported rates of electroencephalogram (EEG) and amplitude-integrated EEG (aEEG) monitoring for detection of neonatal seizures, prevalent use of older anticonvulsant agents, and high rates of neuroimaging. Overall, responses were similar for term and preterm neonates, however term neonates were more likely to be more heavily investigated, with higher use of EEG and aEEG monitoring of at-risk neonates and higher use of MRI. Continuous monitoring and brain imaging in the setting of neonatal seizures are now standard of care in many centers, though management practices vary widely. Early recognition and management of neonatal seizures and possible underlying injury may lead to increased opportunities for stopping seizures, protecting the brain, and improving developmental outcomes in at risk neonates. There is urgent need for collaboration among neonatologists and neurologists to address the gaps in knowledge regarding management of neonatal seizures in term and preterm neonates.

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“…Magnetic resonance imaging (MRI) is accepted as the gold standard imaging modality. [12] However, Transfontanelle ultrasonography (US) should be performed in emergency cases where MRI is not immediately available. Infants should be monitored with continuous video EEG if possible.…”

Section: Non-epileptic Paroxysmal Movementsmentioning

confidence: 99%

Selektif embolizasyonla tedavi edilmiş tonsillektomi sonrası ciddi kanama: Lingual arter psödoanevrizması

Ünsal¹,

Rıfkı²,

Uysal³

et al. 2016

Sisli Etfal

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N eonatal convulsions are one of the most common emergency neurological diseases in the neonatal period. Since the potential adverse effects of convulsions on the brain are known, they must be treated urgently. In recent years, many studies have examined the use of anticonvulsant drugs in the newborn period; however, there is currently no standardized treatment protocol for neonatal convulsion management. A convulsion is defined as a transient change in neurological function caused by a sudden, paroxysmal depolarization of a group of neurons. In cases of convulsions seen in the neonatal period, it is important to consider the seriousness of potential underlying diseases, the treatments that might be applied targeted at the etiology, and to remember that repetitive convulsions may have a permanent effect on the brain. [1,2] The frequency of neonatal convulsion has been reported to be 1.5 to 3 in 1000 live births. [3] Pathophysiology Neonates have immature neurons and differences in neurotransmitter levels make them susceptible to seizures. [4] Immature neurons contain a larger number of excitatory N-methyl-D-aspartate and α-amino-3-hydroxy-5-methyl-4isoxazolpropionic acid (AMPA) receptors, and fewer gamma-aminobutyric acid (GABA) receptors, which is one of the reasons for a low convulsion threshold in neonates. In addition, unlike in adults, GABAA receptors in neonates work as excitators through sodium-potassium-chloride cotransporter 1 (NKCC1), which also contributes to a low convulsion threshold. [5] (Fig. 1) In addition, in cases of hypoxia, the NKCC1 channel is upregulated and the convulsion threshold is decreased even more. Neonatal convulsions are one of the most common emergency neurological events in the early period after birth. The frequency has been reported to be 1.5 to 3 in 1000 live births. It has been established that the convulsion threshold is lower in infants due to immature neonatal neurons and differences in neurotransmitters. Hypoxic ischemic encephalopathy is the most common etiology in neonatal convulsions. Other causes vary, and may be related to the level of development of the country. Convulsions are classified into 4 different types according to the clinical findings. The most common is the subtle (undefined) type of seizure; the other types are defined as clonic, tonic, and myoclonic seizures. Non-epileptic paroxysmal movements frequently seen in the neonatal period, should not be confused with seizures. The most common non-epileptic paroxysmal movements are jitteriness, benign neonatal sleep myoclonus, and hyperekplexia. A newborn that experiences convulsions should be hospitalized and monitored with continuous video electroencephalogram, if possible. If an initial rapid evaluation detects an acute metabolic disorder, treatment is provided, and, if warranted, it will be followed by a plan for further treatment with anticonvulsant drugs. Phenobarbital is still currently recommended as first-line therapy, though there are studies of other anticonvulsant drugs. Levetiracetam and phenytoin...

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Magnetic Resonance Imaging and Ultrasound Injury in Preterm Infants With Seizures

Cited by 24 publications

References 27 publications

A study of neurosonogram abnormalities, clinical correlation with neurosonogram findings, and immediate outcome of high-risk neonates in Neonatal Intensive Care Unit

A study of neurosonogram abnormalities, clinical correlation with neurosonogram findings, and immediate outcome of high-risk neonates in Neonatal Intensive Care Unit

Neonatal Seizures: Treatment Practices Among Term and Preterm Infants

Selektif embolizasyonla tedavi edilmiş tonsillektomi sonrası ciddi kanama: Lingual arter psödoanevrizması

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