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Neonatal seizures – current view of the issue


Authors: K. Španělová;  K. Česká;  H. Ošlejšková;  Š. Aulická
Authors‘ workplace: Centrum pro epilepsie, Klinika dětské neurologie LF MU a FN Brno
Published in: Cesk Slov Neurol N 2020; 83(1): 48-56
Category: Review Article
doi: https://doi.org/10.14735/amcsnn202048

Overview

The newborn period poses the most vulnerable time in the development of epileptic seizures. The main predisposing factor is an increased neuronal excitability resulting from the incomplete maturation of a premature brain. From this point of view, premature newborns are at the highest risk of developing neonatal seizures. Early initiation of rational dia­gnostic and therapeutic intervention is often complicated by the vague or absent clinical manifestation of neonatal seizures. The variability of their clinical picture is reflected in the new draft of Neonatal Seizure Classification by International League Against Epilepsy (ILAE) from 2018. Timely dia­gnosis and initiation of adequate therapy with regard to etiology is, from the prognosis viewpoint, crucial. The strongest predictor of prognosis is etiology, as well as gestational age, initial findings during the neurological examination and ictal and interictal electroencephalographic features.

Keywords:

classification – therapy – neonatal seizures – EEG


Sources

1. Vasudevan C, Levene M. Epidemiology and aetiology of neonatal seizures. Semin Fetal Neonatal Med 2013; 18(4): 185–191. doi: 10.1016/ j.siny.2013.05.008

2. Glass HC, Shellhaas RA, Wusthoff CJ et al. Contemporary profile of seizures in neonates: a prospective cohort study. J Pediatr 2016; 174: 98–103. doi: 10.1016/ j.jpeds.2016.03.035

3. Uria-Avellanal C, Marlow N, Rennie JM. Outcome following neonatal seizures. Semin Fetal Neonatal Med 2013; 18(4): 224–232. doi: 10.1016/ j.siny.2013.01.002

4. Boylan GB, Pressler RM, Rennie JM et al. Outcome of electroclinical, electrographic, and clinical seizures in the newborn infant. Devl Med Child Neurol 2007; 41(12): 819–825. doi: 10.1017/ s0012162299001632.

5. Shellhaas RA, Wusthoff CJ, Tsuchida TN et al. Profile of neonatal epilepsies: characteristics of a prospective US cohort. Neurology 2017; 89(9): 893–899. doi: 10.1212/ WNL.0000000000004284

6. Abend NS, Jensen FE, Inder TE et al. Neonatal Seizures. In: Volpe’s neurology of the newborn. Amsterdam: Elsevier 2018: 275–321.

7. Pressler RM. Neonatal seizures. [online]. Avail­able from URL: https:/ / www.epilepsysociety.org.uk/ sites/ default/ files/ attachments/ Chapter06Pressler2015.pdf.

8. Jensen FE. Neonatal seizures: an update on mechanisms and management. Clin Perinatol 2009; 36(4): 881–900. doi: 10.1016/ j.clp.2009.08.001

9. Jiang Q, Wang J, Wu X et al. Alterations of NR2B and PSD-95 expression after early-life epileptiform discharges in developing neurons. Int J Dev Neurosci 2007; 25(3): 165–70. doi: 10.1016/ j.ijdevneu.2007.02.001

10. Glass HC. Neonatal seizures: advances in mechanisms and management. Clin Perinatol 2014; 41(1): 177–190. doi: 10.1016/ j.clp.2013.10.004

11. Hooper A, Fuller PM, Maguire J. Hippocampal corticotropin-releasing hormone neurons support recognition memory and modulate hippocampal excitability. PLOS ONE 2018; 13(1): e0191363. doi: 10.1371/ journal.pone.0191363

12. Eyo UB, Murugan M, Wu LJ. Microglia-neuron communication in epilepsy. Glia 2017; 65(1), 5–18. doi: 10.1002/ glia.23006.

13. Koh S. Role of neuroinflammation in evolution of childhood epilepsy. J Child Neurol 2018; 33(1): 64–72. doi: 10.1177/ 0883073817739528

14. Ritzel RM, Patel AR, Pan S et al. Age- and location-related changes in microglial function. Neurobio­l Aging 2015; 36(6): 2153–2163. doi: 10.1016/ j.neurobio­laging.2015.02.016.

15. Hiragi T, Ikegaya Y, Koyama R. Microglia after seizures and in epilepsy. Cells 2018; 7(4). pii: E26. doi: 10.3390/  cells7040026.

16. Ben-Ari Y, Holmes GL. Effects of seizures on developmental processes in the immature brain. Lancet Neurol 2006; 5(1): 1055–1063. doi: 10.1016/ S1474-4422(06)70626-3.

17. Nardou R, Ferrari DC, Ben-Ari Y. Mechanisms and effects of seizures in the immature brain. Semin Fetal Neonatal Med 2013; 18(4): 175–184. doi: 10.1016/ j.siny.2013.02.003.

18. Holmes GL. Effect of seizures on the developing brain and cognition. Semin Pediatr Neurol 2016; 23(2): 120–126. doi: 10.1016/ j.spen.2016.05.001.

19. Sankar R, Shin DH, Wasterlain CG. GABA metabolism during status epilepticus in the developing rat brain. Brain Res Dev Brain Res 1997; 98(1): 60–64. doi: 10.1016/ S0165-3806(96)00165-4.

20. Panayiotopoulos CP. The epilepsies: seizures, syndromes and management. 2nd edition. In: Panayiotopoulos CP. Chapter 5: Neonatal seizures and neonatal syndromes. Chipping Norton, England: Bladon Medical Publishing 2005.

21. Scheffer IE, Berkovic S, Capovilla G et al. ILAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology. Epilepsia 2017; 58(4): 512–521. doi: 10.1111/ epi.13709.

22. Nagarajan L, Palumbo L, Ghosh S. Brief electroencephalography rhythmic discharges (BERDs) in the neonate with seizures: their significance and prognostic implications. J Child Neurol 2011; 26(12): 1529–1533. doi: 10.1177/ 0883073811409750.

23. Oliveira AJ, Nunes ML, Haertel LM et al. Duration of rhythmic EEG patterns in neonates: new evidence for clinical and prognostic significance of brief rhythmic discharges. Clin Neurophysiol 2000; 111(9): 1646–1653. doi: 10.1016/ s1388-2457(00)00380-1.

24. Boylan GB, Rennie JM, Pressler RM et al. Phenobarbitone, neonatal seizures, and video-EEG. Arch Dis Child Fetal Neonatal Ed 2002; 86(3): F165–F170. doi: 10.1136/ fn.86.3.F165

25. Janáčková S, Boyd S, Yozawitz E et al. Electroencepha­lographic characteristics of epileptic seizures in preterm neonates. Clin Neurophysiol 2016; 127(6): 2721–2727. doi: 10.1016/ j.clinph.2016.05.006

26. Mizrahi EM, Kellaway P. Characterization and classification of neonatal seizures. Neurology 1987; 37(12): 1837–1844. doi: 10.1212/ WNL.37.12.1837

27. Fernández IS, Loddenkemper T. aEEG and cEEG: Two complementary techniques to assess seizures and encephalopathy in neonates: editorial on “Amplitude-integrated EEG for detection of neonatal seizures: a systema­tic review” by Rakshasbhuvankar et al. Seizure 2015; 33: 88–89. doi: 10.1016/ j.seizure.2015.10.010

28. Pisani F, Pavlidis E. The role of electroencephalogram in neonatal seizure detection. Expert Rev Neurother 2018; 18(2): 95–100. doi: 10.1080/ 14737175.2018.1413352

29. International League Against Epilepsy. Neonatal seizure classification. [online]. Available from URL: https:/ / www.ilae.org/ files/ dmfile/ NeonatalSeizureClassification-ProofForWeb.pdf.

30. Axeen EJT, Olson HE. Neonatal epilepsy genetics. Sem Fetal Neonatal Med 2018; 23(3): 197–203. doi: 10.1016/ j.siny.2018.01.003

31. Komárek V. Léčba epileptických syndromů u dětí. Cesk Slov Neurol N 2007; 70/ 103(5): 473–485.

32. Poduri A, Lowenstein D. Epilepsy genetics – past, present, and future. Curr Opin Genet Dev 2011; 21(3): 325–332. doi: 10.1016/ j.gde.2011.01.005.

33. Beal JC, Cherian K, Moshe SL. Early-onset epileptic encephalopathies: Ohtahara syndrome and early myoclonic encephalopathy. Pediatr Neurol 2012; 47(5): 317–323. doi: 10.1016/ j.pediatrneurol.2012.06.002.

34. Tadic BV, Kravljanac R, Sretenovic V et al. Long--term outcome in children with neonatal seizures: a tertiary center experience in cohort of 168 patients. Epilepsy Behav 2018; 84: 107–113. doi: 10.1016/ j.yebeh.2018.05.002.

35. Inoue T, Shimizu M, Hamano S et al. Epilepsy and West syndrome in neonates with hypoxic-ischemic encephalopathy. Pediatr Int 2014; 56(3): 369–372. doi: 10.1111/ ped.12257.

36. Shellhaas R. Treatment of neonatal seizures. [online]. Available from URL: https:/ / www.uptodate.com/ contents/ treatment-of-neonatal-seizures.

37. Aulická Š, Aulický P, Česká K et al. Generalizovaný konvulzivní status epilepticus v dětském věku. Anest intenziv Med 2018; 29(3): 139–147.

38. Yozawitz E, Stacey A, Pressler RM. Pharmacotherapy for seizures in neonates with hypoxic ischemic encephalopathy. Paediatr Drugs 2017; 19(6): 553–567. doi: 10.1007/ s40272-017-0250-4.

39. Kang SK, Kadam SD. Neonatal seizures: impact on neurodevelopmental outcomes. Front Pediatr 2015; 3: 101. doi: 10.3389/ fped.2015.00101.

40. Pisani F, Spagnoli C. Neonatal seizures: a review of outcomes and outcome predictors. Neuropediatrics 2016; 47(1): 12–19. doi: 10.1055/ s-0035-1567873.

41. Gokce-Samar Z, Ostrowsky-Coste K, Gauthier-Morel D et al. Predictive factors and prognostic value for status epilepticus in newborns. Eur J PaediatrNeurol 2019; 23(2): 270–279. doi: 10.1016/ j.ejpn.2019.01.006.

42. Buraniqi E, Sansevere AJ, Kapur K et al. Electrographic seizures in preterm neonates in the neonatal intensive care unit. J Child Neurol 2017; 32(10): 880–885. doi: 10.1177/ 0883073817713918.

43. The ILAE Classification of Seizures & the Epilepsies: Modification for Seizures in the Neonate. Proposal from the ILAE Task Force on Neonatal Seizures. [online]. Avail­able from URL: https:/ / www.ilae.org/ files/ dmfile/ NeonatalSeizureClassification-ProofForWeb.pdf

Labels
Paediatric neurology Neurosurgery Neurology Paediatrics General practitioner for children and adolescents

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Czech and Slovak Neurology and Neurosurgery

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