Pattern of Brain Injury Predicts Long-Term Epilepsy Following Neonatal Encephalopathy
| Autor: | Alan Hill, Jill G. Zwicker, Hao Chen, Peter K. H. Wong, Steven P. Miller, Qi Xu, Emily W.Y. Tam, Katherine Muir, Elke H. Roland, Kenneth J. Poskitt, Vann Chau, Darren S. T. Wong, C Sanguansermsri |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Electroencephalography Hypoxic Ischemic Encephalopathy 03 medical and health sciences Epilepsy 0302 clinical medicine Hypothermia Induced 030225 pediatrics medicine Humans Child Retrospective Studies medicine.diagnostic_test Neonatal encephalopathy business.industry Infant Newborn Brain Infant Magnetic resonance imaging Retrospective cohort study medicine.disease Magnetic Resonance Imaging Term (time) Child Preschool Hypoxia-Ischemia Brain Pediatrics Perinatology and Child Health Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Child Neurology. 34:199-209 |
| ISSN: | 1708-8283 0883-0738 |
| DOI: | 10.1177/0883073818822361 |
| Popis: | Objective: To determine if patterns of hypoxic-ischemic brain injury on magnetic resonance imaging (MRI) in term newborns predict subsequent childhood epilepsy. Methods: This retrospective cohort study includes term newborns with encephalopathy (n = 181) born between 2004-2012 and admitted to British Columbia Children’s Hospital. MRI was performed between 3 and 5 days of age. The predominant patterns of hypoxic-ischemic injury were classified as Normal, Watershed, Basal Nuclei, Total, and Focal-Multifocal. Lesions in hippocampus, motor and occipital cortex were noted. Results: Of 181 newborns, 166 (92%) survived the neonatal period, and 132 (80%) had follow-up with a median duration of 61 months (IQR: 28–95). Twenty-three children (17%) developed epilepsy. A higher proportion with Watershed, Basal Nuclei, or Total patterns developed epilepsy ( P < .001). Injury to motor cortex, hippocampus, and occipital lobe ( P < .01) were independent risk factors for epilepsy. In the adjusting logistic model, Watershed (odds ratio = 16.0, 95% CI [1.3, 197.2], P = .03) and Basal Nuclei injury (odds ratio = 19.4, 95% CI [1.9, 196.3], P = .01) remained independent risk factors. Therapeutic hypothermia did not alter these associations. Severity of brain injury and recurrent neonatal seizures are other clinical risk factors. Significance: In term newborns with hypoxic-ischemic encephalopathy, the predominant pattern of Watershed and Basal Nuclei injury are valuable predictors for development of epilepsy in later childhood. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|