Early development of epileptic infants with pre- or perinatal brain injuries: role of the epileptic disorder.
To try to understand the causative role of epilepsy PER SE in the developmental deterioration of brain injured infants, twenty-eight infants affected with early acquired, pre- and perinatal brain injuries were enrolled and divided into three groups, a) those with West syndrome, b) those with other non-West epilepsies, and c) those without epilepsy. Developmental monitoring consisted of a full clinical assessment, including examination of visual function, Griffiths developmental scales, standard EEG, long-term monitoring when necessary, and MRI, from the seizure onset or the first observation to the end of follow-up. Patients with epilepsy showed at study onset abnormal clinical features (neurological and developmental) distinct from those of non-epileptic patients, partially due to the varying severity of their brain injuries. A definite differentiation between groups was observed in the clinical evolution that showed among the epileptic patients, mostly in West syndrome, a significant deterioration. Moreover, impaired visual function at seizure onset was possibly associated with a bad developmental evolution. A developmental deterioration, mostly in West syndrome, accounts for a causative role of the epileptic disorder PER SE, but in few cases it was also observed in infants with only a brain injury, suggesting other aetiopathogenic mechanisms. The predictive value of early visual function seems to be confirmed.
Barone
M R
MR
Department of Child Neurology and Psychiatry, Catholic University, Rome, Italy.
Battaglia
D
D
Veredice
C
C
De Waure
C
C
Ricci
D
D
Baranello
G
G
Mercuri
E
E
Guzzetta
F
F
D001930:Brain Injuries / Q000150:complications*; D004569:Electroencephalography / Q000379:methods; D004827:Epilepsy / Q000175:diagnosis* / Q000209:etiology*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods; D008609:Mental Status Schedule; D009460:Neurologic Examination / Q000379:methods; D012189:Retrospective Studies; D014741:Video Recording / Q000379:methods; D014786:Vision Disorders / Q000209:etiology; D014794:Visual Fields / Q000502:physiology