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Neonatal seizures: magnetic resonance imaging adds value in the diagnosis and prediction of neurodisability
Author(s) -
Osmond Elizabeth,
Billetop Amiel,
Jary Sally,
Likeman Marcus,
Thoresen Marianne,
Luyt Karen
Publication year - 2014
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12583
Subject(s) - medicine , magnetic resonance imaging , etiology , pediatrics , cohort , encephalopathy , epilepsy , cohort study , neuroimaging , neonatal seizure , neonatal encephalopathy , gestation , radiology , pregnancy , psychiatry , genetics , biology
Aim To determine the aetiological associations, neurological sequelae and role of magnetic resonance imaging ( MRI ) in term newborn infants with seizures. Methods Cohort study of infants ≥37 weeks' gestation delivered in a tertiary level centre, prospectively identified and followed longitudinally for 18–24 months. Results An underlying aetiology was found in 95% of the 77 infants identified with seizures (3.0/1000 live births). The most common diagnosis was hypoxic–ischaemic encephalopathy ( HIE ) (65%), followed by neonatal stroke (12%). Nine infants died, 28 of the 68 survivors developed neurodevelopmental impairment ( NDI ), and 15 had recurrent seizures in the first 2 years, with both outcomes more likely in those with a diagnosis other than HIE . Abnormal MRI findings were found in 45 of the 70 infants imaged. The absence of major cerebral lesions was highly predictive of a normal neurological outcome. Conclusion We report the first cohort of term infants with seizures fully investigated by MRI . The universal use of MRI enabled a cause to be identified in 95% of cases. The probability of having NDI or recurrence of seizures was extremely low with absence of major cerebral lesions on MRI . This study demonstrates the added value of MRI for diagnosis of aetiology and the prediction of neurological outcome.