Practical aspects of diagnosis and treatment of neonatal seizures
Abstract
Aim – analyze the current practice of management in patients with neonatal seizures and perinatal brain disorders, and determine the ways to prevent long-term neurological complications.
Materials and methods. The study group included 140 children (aged from 2 weeks to 18 months) with neonatal seizures and perinatal brain abnormalities. In these cases, the obstetric and early postnatal history was analyzed; all patients underwent video-EEG monitoring, cervical spine X-ray, neuroimaging, and a Doppler ultrasound test.
Results. We found a number of reliable ante- and intra- partum predictors of neonatal seizures. According to the medical documentation from the neonatal pathology departments, local neonatologists have difficulties in diagnosing and verifying the type and duration of seizures. In most patients with neonatal seizures, we detected epileptiform EEG activity, signs of birth defects (according to X-ray) and marked changes (according to neuroimaging) in the cervical spine.
Conclusion. The results confirm that neonatal seizures are one of the first symptoms of severe brain damage, including intra-natal damage. Evolution of neonatal seizures into drug-resistant epilepsy and further disability is associated with insufficient knowledge of neonatal seizures, standards for their diagnosis, therapy and multidisciplinary observation.
About the Authors
E. A. Morozova
Kazan State Medical Academy.
Russian Federation
Russian Federation
Elena A. Morozova – MD, Professor at the Department of Pediatric Neurology.
11 Mushtari Str., Kazan 420012.
R. R. Sergeeva
Pediatric City Hospital No. 8, Kazan city.
Russian Federation
Russian Federation
Rimma R. Sergeeva – MD, Neurologist.
11 B. Galeeva Str., Kazan 420012,.
D. V. Morozov
Kazan State Medical Academy.
Russian Federation
Russian Federation
Dmitry V. Morozov – MD, PhD, Assistant Professor at the Department of Pediatric Neurology.
11 Mushtari Str., Kazan 420012.
References
1. Pisani F., Facini C., Pavlidis E., Spagnoli C., Boylan G. Epilepsy after neonatal seizures: Literature review. European journal of pediatric neurology. 2015; 19: 6-14.
2. Morozova E. A., Sergeeva R. R., Petrova A. V., Bagirova S. F., Shajmardanova G. A. The role of perinatal factors in the formation of neuropsychiatric disorders. Prakticheskaya medicina. 2017; 1 (3): 127 s. (in Russian).
3. Morozova E. A. Clinical evolution of perinatal pathology of the brain. Abstract of dissertation for the degree of Doctor of Medical Sciences. Kazan’. 2012. (in Russian).
4. Siddharth V. J., Amit M., Srinivasakumar P., Wallendor M., Culver J. P., Zempel J. M. Prediction of Neonatal Seizures in Hypoxic-Ischemic Encephalopathy Using Electroencephalograph Power Analyses. Pediatric Neurology. May 2017; 64-70.e2.
5. Guzeva V. I. Epilepsy and non-epileptic paroxysmal states in children: monograph. Moscow. 2007; 568 s. (in Russian).
6. Petruxin A. S. Epileptology of childhood: a guide for doctors. Moscow. 2000; 624 s. (in Russian).
7. Donovan M. D., Griffin B. T., Kharoshankaya L., Cryan J. F. andBoylan G. B. Pharmacotherapy for Neonatal Seizures: Current Knowledge and Future Perspectives. Drugs. 2016; 76 (6): 647-661.
8. Zavadenko A. N., Medvedev M. I., Degtyareva M. G., Rogatkin S. O., Zavadenko N. N. Causes of neonatal seizures in children of different gestational age. Epilepsiya i paroksizmal’nye sostoyaniya / Epilepsy and paroxysmal conditions. 2018;10(3):19-30. https://doi.org/10.17749/2077-8333.2018.10.3.019-030.
9. Spagnoli C., Cilio M. R., Pavlidis E., Pisani F. Symptomatic Neonatal Seizures Followed by Febrile Status Epilepticus: The two-Hit Hypothesis for the Subsequent Development of Epilepsy. Journal of Child Neurology. 2014; 30 (5): 615-618.
10. Christine K. Fox, Hannah C. Glass, Stephen Sidney, Sabrina E. Smith, Heather J. Fullerton. Neonatal seizures triple the risk of a remote seizure after perinatal ischemic stroke. Neurology, 2016; 86:1–8.
11. Fox C. K., Glass H. C., Sidney S., Smith S. E., Fullerton H. J. Neonatal seizures triple the risk of a remote seizure after perinatal ischemic stroke. Neurology. 2016; 86: 1-8.
12. Baumer F. M., Wusthoff C. J. Neonatal seizures: evaluation, treatment and prognosis. In: Fetal and neonatal brain injury. Eds. Stevenson D. K., Benitz W. E., Sunshine Ph., Hintz S. R., Druzin M. L. 5th ed. Cambridge University Press. 2018; 655-681.
13. Pisania F., Facinia C., Pelosib A., Mazzottaa S., Spagnolia C., Pavlidisa E. Neonatal seizures in preterm newborns: A predictive model for outcome. European Journal of Paediatric Neurology. March 2016; 243-251.
14. Murrey D. M., Ryan C. A., Boylan C. B. Prediction of seizures in asphyxiated neonates: correlation with continuous videoelectroencephalographic monitoring. Pediatrics. 2006; 1: 1140-1151.
15. Nagarajan L., Palumbo N. L. Neurodevelopmental Outcomes in Neonates With Seizures: A Numerical Score of Background Electroencephalography to Help Prognosticate. J. Child. Neurol. 2010; 25 (8): 961-968.
16. Gano D., Sargent M. A., Miller S. P. et al. MRI findings in infants with infantile spasms after neonatal hypoxic-ischemic encephalopathy. Pediatr Neurol. 2013; 49: 401-17.
17. Lombroso C. T. Neonatal seizures I C. T. Lombroso II Epilepsy: diagnosis and management Eds. Brown T., Feldman R. Boston. 1983; 297-313.
18. Nicholas S., Huh H., Mark A., Dennis J. Anticonvulsant Medications in the Pediatric Emergency Room and Intensive Care Unit. Pediatric Emergency Care. 2008; 24 I (10): 705-718.
19. Vasudevan C., Levene M. Epidemiology and aetiology of neonatal seizures. Seminars in Fetal & Neonatal Medicine. 2013; 18 (4):185-191.
20. Babkin P. S. Childbirth and newborn: Evolutionary, neurogenic and iatrogenic problems: monograph. Voronezh. 2004; 248 s. (In Russian).
21. Mixajlov M. K. Neurorententology of childhood. Kazan. 1983; 117 s. (In Russian).
22. Ratner A. Yu. Birth injuries of the nervous system. Kazan. 1985; 332 s. (In Russian).
For citation:
Morozova E.A., Sergeeva R.R., Morozov D.V. Practical aspects of diagnosis and treatment of neonatal seizures. Epilepsy and paroxysmal conditions. 2018;10(4):17-25. (In Russ.) https://doi.org/10.17749/2077-8333.2018.10.4.017-025
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