title: Risk factors for epilepsy in children with neonatal encephalopathy.
abstract: We examined neonatal predictors of epilepsy in term newborns with neonatal encephalopathy (NE) by studying children enrolled in a longitudinal, single center cohort study. Clinical data were obtained through chart review, and MRI was performed in the neonatal period. We administered a seizure questionnaire to parents of children aged ≥ 12 mo (range, 12 mo to 16.5 y) to determine the outcome of epilepsy. The association between clinical predictors and time to onset of epilepsy was assessed using Cox proportional hazards regression. Thirteen of 129 children developed epilepsy: all had neonatal seizures and brain injury on neonatal MRI. Of the newborns with neonatal seizures, 25% (15.8/1000 person-years) developed epilepsy, with the highest hazard ratios (HRs) in the newborns with status epilepticus (HR, 35.8; 95% CI, 6.5-196.5). Children with severe or near-total brain injury were more likely to develop epilepsy compared with those with only mild or moderate injury (HR, 5.5; 95% CI, 1.8-16.8). In a multivariable analysis adjusting for degree of encephalopathy and severe/near-total brain injury, status epilepticus was independently associated with epilepsy. These data add to information regarding epilepsy pathogenesis and further aid clinicians to counsel parents regarding the likelihood that a newborn with NE will develop epilepsy.
authors.affiliation: Department of Neurology, University of California at San Francisco, San Francisco, California 94143, USA. hannah.glass@ucsf.edu
authors.forename: Hannah C
authors.initials: HC
authors.lastname: Glass
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Hong
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Rogers
authors.forename: Rita J
authors.initials: RJ
authors.lastname: Jeremy
authors.forename: Sonia L
authors.initials: SL
authors.lastname: Bonifacio
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Sullivan
authors.forename: A James
authors.initials: AJ
authors.lastname: Barkovich
authors.forename: Donna M
authors.initials: DM
authors.lastname: Ferriero
mesh_terms: D000293:Adolescent; D002140:California; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004827:Epilepsy / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000150:complications* / Q000453:epidemiology; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D016016:Proportional Hazards Models; D012307:Risk Factors; D013226:Status Epilepticus / Q000150:complications*; D011795:Surveys and Questionnaires