title: Hypothermia reduces seizure burden and improves neurological outcome in severe hypoxic-ischemic encephalopathy: an observational study.
abstract: OBJECTIVE
  To evaluate the antiepileptic effect of hypothermia and its association with neurological outcome in infants with moderate and severe hypoxic-ischemic encephalopathy (HIE).
  
  
  METHODS
  We compared polygraphic electroencephalography monitoring and outcome data in 39 cooled and 33 non-cooled term newborn infants, born between January 2005 and March 2013, and hospitalized because of signs of asphyxia and moderate to severe HIE.
  
  
  RESULTS
  Cooled newborn infants had fewer seizures (14/39 vs 20/33 p=0.036) and status epilepticus (7/39 vs 13/33, p=0.043), a lower mean duration of seizures (18mins vs 133mins, p=0.026), fewer administered antiepileptic drugs (median 0 vs 1, p=0.045), and more commonly a good outcome at 24 months (normal/mild motor impairment in 32/39 vs 16/33, p=0.003). Seizure burden (accumulated duration of seizures over a defined period) in cooled patients with both moderate (0.0 vs 0.1; p=0.045) and severe HIE (0.3 vs 4.9; p=0.018) was lower than in non-cooled patients. Compared with non-cooled patients, a good outcome was more common in cooled newborn infants with severe HIE (p=0.003).
  
  
  CONCLUSIONS
  Hypothermia has an antiepileptic effect in both moderate and severe neonatal HIE. The lower seizure burden in cooled newborn infants with severe HIE is more commonly associated with normal outcome at 24 months.
authors.affiliation: Division of Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital, Modena, Italy.
authors.forename: Isotta
authors.initials: I
authors.lastname: Guidotti
authors.affiliation: Division of Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital, Modena, Italy.
authors.forename: Licia
authors.initials: L
authors.lastname: Lugli
authors.affiliation: Division of Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital, Modena, Italy.
authors.forename: Maria Pina
authors.initials: MP
authors.lastname: Guerra
authors.affiliation: Division of Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital, Modena, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Ori
authors.affiliation: Division of Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital, Modena, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Gallo
authors.affiliation: Division of Neuroradiology, Department of Neuroscience, Nuovo Ospedale Civile Sant'Agostino Estense, Modena, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Cavalleri
authors.affiliation: Regional Agency for Environmental Prevention, Reference Center for Environment and Health, Modena, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Ranzi
authors.affiliation: Division of Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital, Modena, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Frassoldati
authors.affiliation: Division of Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital, Modena, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Berardi
authors.affiliation: Division of Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital, Modena, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Ferrari
mesh_terms: D004569:Electroencephalography; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D020925:Hypoxia-Ischemia, Brain / Q000150:complications / Q000628:therapy*; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods*; D012189:Retrospective Studies; D012640:Seizures / Q000209:etiology / Q000517:prevention & control*; D012720:Severity of Illness Index