Neonatal seizures: gaps between the laboratory and the clinic.
Seizures in neonates (NBs) remain the most frequent neurological problem in the nursery. Considerable debate about their consequences exists between data and deductions reached through animal experimentations and those obtained through clinical investigations. The main conflicting issues are whether seizures in NBs can plant the roots for epileptogenesis and cause long-term deficits. The purpose of this chapter is to evaluate both laboratory and clinical results.


METHODS
Clinical data will be presented, including a 20-year-long cohort of NBs. This will be followed by the main seminal discoveries obtained in neonatal models. The phenomenon of transient or persistent dysmaturity following NB seizures will be discussed in relation to etiological factors.


RESULTS
The findings and deductions from animal models support the notions that epileptogenesis and cognitive deficits result from NB seizures. These conclusions contrast with clinical investigations maintaining that NB seizures, per se, are symptomatic markers of preexisting or of ongoing morbidities. The reasons for contrasting views will be discussed. Suggestions will be advanced for more animal models whose seizures are consistent with the etiologies and the phenotypes of human NB seizures.
Lombroso
Cesare T
CT
Department of Neurology, Children's Hospital and Department of Neurology, Harvard Medical School, Boston, Massachusetts, USA. Lombrosoc@aol.com
D000818:Animals; D001921:Brain / Q000254:growth & development / Q000503:physiopathology*; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology; D015331:Cohort Studies; D004195:Disease Models, Animal; D004569:Electroencephalography / Q000706:statistics & numerical data; D020936:Epilepsy, Benign Neonatal / Q000209:etiology* / Q000503:physiopathology*; D006801:Humans; D007696:Kindling, Neurologic / Q000502:physiology; D010641:Phenotype; D017286:Polysomnography; D051381:Rats; D012107:Research Design / Q000706:statistics & numerical data / Q000639:trends; D012890:Sleep / Q000502:physiology; D013997:Time Factors; D050994:Voltage-Dependent Anion Channels; D005680:gamma-Aminobutyric Acid / Q000502:physiology
D050994:Voltage-Dependent Anion Channels; D005680:gamma-Aminobutyric Acid