Which neonatal seizure findings on EEG predict neurodevelopmental outcome?

Updated: Oct 03, 2019
  • Author: Rosalia C Silvestri-Hobson, MD; Chief Editor: Selim R Benbadis, MD  more...
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Answer

Follow-up studies on the incidence of epilepsy following clinical neonatal seizures yield different results. According to Ronen et al, results from a population-based study with more than 10 years follow-up, show the risk being highest for premature babies. [24] The remote symptomatic epilepsies are usually accompanied by motor and cognitive comorbidities, mortality being seen only among patients whose epilepsy was associated with mental retardation and cerebral palsy. An adverse outcome (ie, death, severe developmental delay, CP) at age 2 years was strongly associated to seizures in preterm babies of very early gestational age and low birth weight.

In the context of neonatal seizures, besides background EEG activity, some ictal findings present on first EEG may hold a prognostic value and predict neurodevelopmental outcome. Among them, the spread of ictal discharge to the contralateral hemisphere and the ictal fraction (total duration of the seizures/EEG duration/hour) might suggest significant prognostic informations since the early hours of life. [25]


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