All issues > Volume 43(2); 2000

Original Article

J Korean Pediatr Soc. 2000;43(2):267-273. Published online February 15, 2000.

Factors Related to the Outcome of Neonatal Seizures

Sung Koo SK Kim¹, Ran R Lee¹, In Kyu IK Lee¹, Ki Joong KJ Kim¹, Young Seung YS Hwang¹

¹Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea

Abstract

Purpose
: Seizures during the neonatal period may be an important indicator of serious neurologic abnormalities and can cause permanent neurologic sequelae. We attempted to find and analyze the factors related to the outcome of neonatal seizures.
Methods
: Seventy-six newborns with seizure were reviewed. The outcomes were analyzed according to etiologic diseases, gestational ages, characteristics of seizure, and neuroimaging and electroencephalographic study findings.
Results
: Of the 76 patients, 29 showed normal outcome, 27 had neurologic sequelae(NS), 7 expired, 7 hopelessly discharged, and 6 were lost during follow-up. Of the 40 with perinatal problems, the outcomes were normal in 19 and NS was found in 16. Of the 36 without perinatal problem, 10 showed normal outcome and 11 had NS. Ten out of 25 with hypoxia showed NS, whereas only 1 out of 11 with late hypocalcemia had NS. Of the 19 whose seizure began within the first 24 hours, 8 had NS, 3 expired and 2 discharged hopelessly. Of the 27 with generalized tonic seizures, 11 were normal and 13 showed NS. Of the 49 with brief but repetitive seizures, 16 showed NS, 6 expired and 5 discharged hopelessly. Twenty-five out of 39 with abnormal neuroimaging findings had abnormal outcomes, whereas 5 out of 20 with normal findings showed NS. Sixteen out of 27 with EEG background abnormalities and 24 out of 46 with epileptiform discharges had NS.
Conclusion
: Neuroimaging and electroencephalographic findings rather than etiologic factors were more important in predicting neurologic outcomes in newborns with seizure.

Keywords :Neonatal seizure, Neurologic sequelae, Outcome