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Factors Related to the Outcome of Neonatal Seizures

Journal of the Korean Pediatric Society 2000;43(2):267-273.
Published online February 15, 2000.
Factors Related to the Outcome of Neonatal Seizures
Sung Koo Kim, Ran Lee, In Kyu Lee, Ki Joong Kim, Young Seung Hwang
Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
신생아 발작의 예후와 관련된 인자
김성구, 이란, 이인규, 김기중, 황용승
서울대학교 의과대학 소아과학교실
Abstract
Purpose
: Seizures during the neonatal period may be an important indicator of serious neurologic abnormalities and can cause permanent neurologic sequelae. We attempted to find and analyze the factors related to the outcome of neonatal seizures.
Methods
: Seventy-six newborns with seizure were reviewed. The outcomes were analyzed according to etiologic diseases, gestational ages, characteristics of seizure, and neuroimaging and electroencephalographic study findings.
Results
: Of the 76 patients, 29 showed normal outcome, 27 had neurologic sequelae(NS), 7 expired, 7 hopelessly discharged, and 6 were lost during follow-up. Of the 40 with perinatal problems, the outcomes were normal in 19 and NS was found in 16. Of the 36 without perinatal problem, 10 showed normal outcome and 11 had NS. Ten out of 25 with hypoxia showed NS, whereas only 1 out of 11 with late hypocalcemia had NS. Of the 19 whose seizure began within the first 24 hours, 8 had NS, 3 expired and 2 discharged hopelessly. Of the 27 with generalized tonic seizures, 11 were normal and 13 showed NS. Of the 49 with brief but repetitive seizures, 16 showed NS, 6 expired and 5 discharged hopelessly. Twenty-five out of 39 with abnormal neuroimaging findings had abnormal outcomes, whereas 5 out of 20 with normal findings showed NS. Sixteen out of 27 with EEG background abnormalities and 24 out of 46 with epileptiform discharges had NS.
Conclusion
: Neuroimaging and electroencephalographic findings rather than etiologic factors were more important in predicting neurologic outcomes in newborns with seizure.
Key Words: Neonatal seizure, Neurologic sequelae, Outcome


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