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Clinical Characteristics of Neonatal Status Epilepticus

Korean Journal of Pediatrics 2005;48(12):1342-1347.
Published online December 15, 2005.
Clinical Characteristics of Neonatal Status Epilepticus
Kyeong Hun Jung, Yun Hee Kim, Young Se Kwon, Yong Hoon Jun, Soon Ki Kim, Byong Kwan Son
Department of Pediatrics, College of Medicine, Inha University, Incheon, Korea
신생아 간질 중첩증의 임상 특성
정경훈, 김윤희, 권영세, 전용훈, 김순기, 손병관
인하대학교 의과대학 소아과학교실
Correspondence: 
Young Se Kwon, Email: ysped@inha.ac.kr
Abstract
Purpose
: Among perinatal risk factors, neonatal seizures are one of the strongest independent discriminators of adverse outcome, representing high risks of mortality and neurologic morbidity. This study was undertaken to evaluate the neurologic outcome of neonatal status epilepticus according to underlying etiology, seizure pattern, onset time, and duration.
Methods
: We reviewed retrospectively 36 neonates(19 males, 17 females) with status epilepticus who were admitted to the neonatal intensive care unit, Inha Hospital between July, 1988 and June, 2003. They were evaluated with neurologic examination, laboratory data, EEG findings, and neuroimaging studies etc.
Results
: The mean gestational period of the patients was 37.0?.6 weeks and birth weight was 2.70?.82 kilogram. Fifty two point eight percent of the neonates were male and 66.7 percent were born at term. The most common cause of neonatal status epilepticus was hypoxic-ischemic encephalopathy. In preterm babies, intracranial hemorrhages showed an especially high frequency(P=0.034). Gestational age and birth weight did not show a correlation with neurologic complications. The incidence of neurological sequelae were significantly related to prolonged seizures lasting more than 1 hour(P=0.002). Neonates with seizures within the first 72 hours tended to be more frequent among those who developed adverse outcomes(P=0.016). Generalized tonic seizures had the worst prognosis, whereas those children who had subtle seizures had better outcomes than any other type(P<0.05). Generalized tonic seizures were primarily represented on EEG by abnormal background, whereas subtle seizure showed a significantly more normal EEG than any other seizures(P<0.05).
Conclusion
: Our results indicate that neonatal status epilepticus with early onsets, prolonged durations. And generalized tonic types can predict an increased risk for neurologic sequelae. So, those seizures must be perceived as medical emergencies and treated aggressively with antiepileptic drugs.
Key Words: Newborn , Seizures , Electroencephalography , Status epilepticus


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