Seizure Scoring System and Neurodevelopmental Outcomes in Very Low Birth Weight Infants with Neonatal Seizures.
- Author:
Hyun Jin KIM
1
;
Byong Sop LEE
;
Mi Sun YUM
;
Hee Jin JANG
;
Sung Hee OH
;
Hyun Jung DO
;
Sung Hoon CHUNG
;
Tae Sung KO
;
Ellen Ai Rhan KIM
;
Ki Soo KIM
Author Information
- Publication Type:Original Article
- Keywords: Neonatal seizure; Seizure scoring system; Very low birth weight infant; Neurodevelopmental outcome
- MeSH: Anticonvulsants; Electroencephalography; Humans; Incidence; Infant*; Infant, Very Low Birth Weight*; Magnetic Resonance Imaging; Multivariate Analysis; Retrospective Studies; Risk Factors; Seizures*; Status Epilepticus
- From:Neonatal Medicine 2013;20(4):428-437
- CountryRepublic of Korea
- Language:Korean
- Abstract: PURPOSE: To evaluate the utility of seizure scoring system in the prediction of neurodevelopmental outcomes in very low birth weight (VLBW) infants who presented with neonatal seizures. METHODS: A retrospective review was performed in VLBW infants who were treated with antiepileptic drugs (AED) for the control of neonatal seizures. A total of 25 infants who survived and were followed-up for at least 2 years of age were included. A new seizure scoring system (the composite score 0-8) was constructed by choosing the following variables: onset, response to the AED, presence of status epilepticus, seizure types and EEG findings including background activity and epileptiform discharges. Neurodevelopmental outcomes were graded from 1 to 5 based on the developmental status and the neurologic abnormalities assessed at 18 to 24 months of postconceptional age. Risk factor analyses for predicting unfavorable outcomes (grade 3-5) versus favorable outcomes (grade 1-2) were performed. RESULTS: Compared to favorable outcome group (n=11), unfavorable outcome group (n=14) had higher incidence of subtle or generalized tonic-type seizures, the abnormal EEG background activity and poor response to AED. The composite seizure score was significantly higher in the unfavorable outcome group (3.2+/-0.7) than in the favorable outcome group (1.2+/-1.2) and it significantly correlated with the neurodevelopmental grading (P<0.001). In multivariate analysis, abnormal MRI findings at term and the composite seizure score were significant risk factors for unfavorable outcomes. CONCLUSION: In VLBW infants with neonatal seizure, the proposed seizure scoring system was a simple and useful predictor of long-term neurologic outcomes.
