title: Pediatric epilepsy following neonatal seizures symptomatic of stroke.
abstract: BACKGROUND
  Neonatal seizures are a risk factor for later epilepsy and their etiology is known to be implicated in the outcome but, little is known about this issue in the subgroup of seizures symptomatic of perinatal arterial ischemic stroke. The aim of this study was to describe the long term risk of epilepsy after electroencephalographic confirmed neonatal seizures symptomatic of perinatal arterial ischemic stroke.
  Fifty-five patients with electroclinical ictal data, vascular territory confirmed by neuroimaging and a minimum follow up of 3.5 years were identified from a multi-centre prospective neonatal seizures registry. Primary outcome was occurrence of post-neonatal epilepsy. The association of outcome with family history of epilepsy, gender, location of the infarct, neonatal clinical and electroencephalogram data were also studied.
  
  
  RESULTS
  During a mean follow up of 8 years and 5 months, 16.4% of the patients developed post neonatal epilepsy. The mean age at first post neonatal seizure was 4 years and 2 months (range 1-10 years and 6 months). Location of the infarct was the only statistically significant risk factor (p=0.001); epilepsy was more represented in males but the difference was not statistically significant.
  
  
  CONCLUSIONS
  Neonatal seizures symptomatic of perinatal arterial ischemic stroke had lower risk and later onset of post-neonatal epilepsy, compared to seizures described in the setting of other perinatal brain insults. Our data have implications for counseling to the family at discharge from neonatal intensive care unit.
authors.affiliation: Child Neurology and Clinical Neurophysiology, Pediatric University Hospital, Padua, Italy. Electronic address: suppiej@pediatria.unipd.it.
authors.forename: Agnese
authors.initials: A
authors.lastname: Suppiej
authors.affiliation: Pediatric Neurology Unit, V. Buzzi Hospital, A.O. ICP, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Mastrangelo
authors.affiliation: Child Neuropsychiatry, Vicenza, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Mastella
authors.affiliation: Child Neuropsychiatric Unit, Civile Hospital, Brescia, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Accorsi
authors.affiliation: Pediatric Unit, Ca' Foncello Hospital, Treviso, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Grazian
authors.affiliation: Department of Pediatrics, Regional Hospital of Bolzano, Bolzano, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Casara
authors.affiliation: Child Neuropsychiatry, Ospedale Maggiore, Novara, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Peruzzi
authors.affiliation: Department of Neurology, Alessandro Manzoni Hospital, Lecco, Italy.
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Carpanelli
authors.affiliation: Division of Neonatology, Santa Maria della Misericordia Hospital Udine, Italy.
authors.forename: Augusta
authors.initials: A
authors.lastname: Janes
authors.affiliation: Child Neurology and Clinical Neurophysiology, Pediatric University Hospital, Padua, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Traverso
authors.affiliation: Unit of Child Neuropsychiatry, University of Verona, Verona, Italy.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Dalla Bernardina
mesh_terms: D017668:Age of Onset; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D002545:Brain Ischemia / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D012306:Risk; D012640:Seizures / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D020521:Stroke / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology
keywords: Arterial ischemic stroke; EEG monitoring; Outcome; Seizures etiology; Thrombosis