Prediction of outcome based on clinical seizure type in newborn infants.
OBJECTIVE
To determine whether the clinical features of neonatal seizures are of value in predicting outcome.


METHODS
Demographic features, clinical seizure types, etiologic factors, and laboratory findings of all 77 patients with seizures admitted to our neonatal intensive care unit over a consecutive 7-year period were extracted from the medical records.


RESULTS
Twenty-three (30%) died; 59% of the survivors had abnormal neurologic examinations, 40% were mentally retarded, 43% had cerebral palsy, and 21% were epileptic at mean follow-up of 3.5 years. Compared with patients with other seizure types, those with subtle and generalized tonic seizures had a significantly higher prevalence of epilepsy (P =.04 and P =.01 respectively); mental retardation (P =.02; P =.007), and cerebral palsy (P =.03; P =.002). Subtle seizures were, in addition, more likely to be associated with abnormalities on the neurologic examination at follow-up (P =.03). Similar outcome comparisons for those with focal and multifocal clonic, focal tonic, and multifocal myoclonic seizures revealed no significant differences. However, patients with >or=2 seizure types were significantly more likely to have epilepsy (P =.02), mental retardation (P =.001), cerebral palsy (P =.001), and abnormal examinations (P =.05).


CONCLUSIONS
Clinical semiology is predictive of outcome in neonates with seizures and suggests the presence of unique pathophysiologic processes for different seizure types.
Brunquell
Philip J
PJ
Division of Neurology, and the Department of Research, Connecticut Children's Medical Center, Hartford, Connecticut 06106, USA.
Glennon
Christina M
CM
DiMario
Francis J
FJ
Lerer
Trudy
T
Eisenfeld
Leonard
L
D002547:Cerebral Palsy / Q000150:complications; D004830:Epilepsy, Tonic-Clonic / Q000150:complications; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases; D008607:Intellectual Disability / Q000150:complications; D008297:Male; D009460:Neurologic Examination; D012189:Retrospective Studies; D012640:Seizures / Q000150:complications* / Q000209:etiology / Q000503:physiopathology