Follow-up of Full-term Neonatal Seizures: Prognostic Factors for Neurodevelopmental Sequelae

ABSTRACT

PURPOSE: The objectives of this study were to observe the major neurodevelopmental sequelae of the full-term neonatal seizures, and to identify the risk factors associated with the poor neurodevelopmental outcomes. METHODS: A retrospective review of the medical records of full-term newborns who had clinical and/or electrographic seizures in neonatal intensive care unit of St. Mary's Hospital between June 1994 to July 2007 was performed. To assess the risk factors associated with poor neurological outcome, various factors were analyzed with univariate analysis and multiple regression analysis (SAS for Windows version 9.2). RESULTS: The most common etiology of seizures in full-term infants was hypoxic ischemic encephalopathy (76.2%). The most common type of seizure was subtle (50.9%), followed by multifocal clonic (41.8%), and the seizure type had no significant correlation to the prognosis. Moderate to major EEG abnormalities were significantly related to poor clinical outcome. Additional factors related to neurodevelopmental outcome were Apgar score at five minute, evidence of HIE on brain MRI, Sarnat stages of HIE, number of anticonvulsant drugs used for seizure control and duration for normalization of EEG abnormalities. CONCLUSION: The risk factors observed in this study may be helpful to predict the neurological outcomes in full-term neonates with seizures.