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Famra K, Batra P, Aggarwal A, Banerjee BD. Prevalence and predictors of adverse outcomes in neonatal seizures. J Neonatal Perinatal Med 2021; 15:29-35. [PMID: 34024787 DOI: 10.3233/npm-200499] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Neonatal seizures are significant cause of neonatal mortality and morbidity. Current study was planned to study prevalence of adverse outcomes in neonatal seizures and identify its predictors. METHODS This observational descriptive study was carried out on 220 neonates with seizures. Neonates who succumbed to illness/ death before investigations, or whose maternal records were incomplete were excluded. Blood sugar, serum calcium, serum electrolytes, and USG skull were done in all patients. CT scan, MRI and inborn errors of metabolism profile were done as and when indicated. Adverse outcomes were defined as death, phenobarbitone non responders, or abnormal examination at discharge. Antenatal, perinatal and neonatal predictors of adverse outcomes in neonatal seizures were evaluated. RESULTS Out of 220 neonates with seizures 76(34.5%) had adverse outcomes. Very low birth weight babies (≤1500 gm) [OR 1.27(CI 0.57-2.84)], microcephaly [OR 5.93 (CI 0.55-64.41)], Apgar score≤3 at 5 minutes [OR 11.28(CI 14.18-30.45)], seizure onset within 24 hours [OR 5.99(CI 12.43-14.78)], meningitis [OR 2.63(CI 0.08-6.39)], septicemia [OR1.22(CI 0.45-3.31)] and abnormal cranial USG [OR 7.95(CI 12.61-24.22)] were significant predictors of adverse outcomes in neonates with seizures. CONCLUSION Prematurity, very low birth weight, birth asphyxia, meningitis, septicemia and abnormal USG could predict adverse outcomes in neonatal seizures. Improved antenatal and neonatal clinical practices may help reduce adverse outcomes in these patients.
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Affiliation(s)
- K Famra
- Department of Paediatrics, University College of Medical sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - P Batra
- Department of Paediatrics, University College of Medical sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - A Aggarwal
- Department of Paediatrics, University College of Medical sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - B D Banerjee
- Department of Biochemistry, University College of Medical sciences and Guru Teg Bahadur Hospital, Delhi, India
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Stomnaroska O, Petkovska E, Jancevska S, Danilovski D. Neonatal Hypoglycemia: Risk Factors and Outcomes. ACTA ACUST UNITED AC 2019; 38:97-101. [PMID: 28593892 DOI: 10.1515/prilozi-2017-0013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIMS Severe neonatal hypoglycemia (HG) leads to neurologic damage, mental retardation, epilepsy, personality disorders, impaired cardiac performance and muscle weakness. We aimed to assess the clinical characteristics of children with hypoglycemia in a random population of newborns. PATIENTS, METHODS AND RESULTS We investigated 84 patients (M:F=35:48) born at the University Clinic for Gynecology and Obstetrics in Skopje (hospitalized in the NICU) who were found to have hypoglycemia. In total 89.25% of the babies were premature. The mean birth weight was 1795.95 +/596.08 grams, the mean birth length was 41.92+/- 4.62 cm, while the mean gestational age was 33.05±3.19 weeks. 32 children (38.08%) were very low birth weight (<1500g), 38 (45.22%) were low birth weight (1500-2500g), while there were 8 children (9.52%) appropriate for age BW and no high BW for age patients (>4000 g). HG duration was 2.42+/-2.41 hours. In the group as a whole, hypoxic-ischemic encephalopathy (HIE) was found in 3 children (3.57%), infections in 22 (26.18%), respiratory distress syndrome (RDS) in 9 patients (10.62%), intracranial haemorrhage in 2 patients (2.38%). There were no inborn errors of metabolism. There were two deaths (2.38%). CONCLUSION Neonatal HG is a significant factor in the overall neonatal mortality. HG can also cause severe invalidity. We found that infections, LBW and low gestational age were most commonly associated with neonatal HG. However the Spearman test showed weak direct correlation, without statistical significance. Neonatal HG requires complex and team interaction of prenatal and postnatal approaches to reduce the incidence of seizures, their consequences and the overall mortality. Special consideration is to be taken in measures that avoid neonatal infections, HIE, LBW and low gestational age. Further studies on a larger population are needed to fully understand and prevent the phenomenon of HG in newborns.
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Affiliation(s)
- Orhideja Stomnaroska
- University Clinic for Gynecology and Obstetrics, Medical Faculty Skopje, Vodnjanska BB, 1000 Skopje
| | | | - Snezana Jancevska
- University Clinic for Gynecology and Obstetrics, Medical Faculty Skopje
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3
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Mochizuki Y, Niimi Y, Sato S, Inoue T, Kuwamoto K, Shima S, Mochizuki T, Kawamata T, Okada Y. Clinical Course and Management of Vein of Galen Varix of the Neonate: A Case Report and Literature Review. Pediatr Neurosurg 2019; 54:281-287. [PMID: 31266039 DOI: 10.1159/000500768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 05/05/2019] [Indexed: 11/19/2022]
Abstract
A 28-year-old pregnant woman underwent an emergency caesarian section after 39 weeks of gestation because of decreased fetal movement and baseline fetal heart rate variability. The neonate was diagnosed with neonatal asphyxia and presented with right cardiac failure due to pulmonary hypertension. The neonate presented convulsion, and plane computed tomography (CT) showed dilation of the vein of Galen and sinuses on day 3. Magnetic resonance imaging and CT with contrast were performed after cardiac failure subsided, and there was no evidence of arteriovenous shunt and normalization of the vein of Galen. The patient was diagnosed with vein of Galen varix (VGV). In the previous literature, only 3 cases of VGV have been reported. VGV is considered to be caused by right cardiac failure without the presence of an arteriovenous shunt and requires treatment only for cardiac failure and its cause. Therefore, it is important to differentiate VGV from vein of Galen aneurysmal malformation.
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Affiliation(s)
- Yuichi Mochizuki
- Department of Neuroendovascular Therapy, St. Luke's International Hospital, Tokyo, Japan, .,Department of Neurosurgery, St. Luke's International Hospital, Tokyo, Japan, .,Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan,
| | - Yasunari Niimi
- Department of Neuroendovascular Therapy, St. Luke's International Hospital, Tokyo, Japan
| | - Shinsuke Sato
- Department of Neuroendovascular Therapy, St. Luke's International Hospital, Tokyo, Japan.,Department of Neurosurgery, St. Luke's International Hospital, Tokyo, Japan.,Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Tatsuya Inoue
- Department of Neuroendovascular Therapy, St. Luke's International Hospital, Tokyo, Japan.,Department of Neurosurgery, St. Luke's International Hospital, Tokyo, Japan.,Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Kentaro Kuwamoto
- Department of Neuroendovascular Therapy, St. Luke's International Hospital, Tokyo, Japan.,Department of Neurosurgery, St. Luke's International Hospital, Tokyo, Japan
| | - Shogo Shima
- Department of Neuroendovascular Therapy, St. Luke's International Hospital, Tokyo, Japan.,Department of Neurosurgery, St. Luke's International Hospital, Tokyo, Japan
| | - Tatsuki Mochizuki
- Department of Neuroendovascular Therapy, St. Luke's International Hospital, Tokyo, Japan.,Department of Neurosurgery, St. Luke's International Hospital, Tokyo, Japan
| | - Takakazu Kawamata
- Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Yoshikazu Okada
- Department of Neurosurgery, St. Luke's International Hospital, Tokyo, Japan
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Pavone P, Corsello G, Ruggieri M, Marino S, Marino S, Falsaperla R. Benign and severe early-life seizures: a round in the first year of life. Ital J Pediatr 2018; 44:54. [PMID: 29764460 PMCID: PMC5952424 DOI: 10.1186/s13052-018-0491-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 04/18/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND At the onset, differentiation between abnormal non-epileptic movements, and epileptic seizures presenting in early life is difficult as is clinical diagnosis and prognostic evaluation of the various seizure disorders presenting at this age. Seizures starting in the first year of life including the neonatal period might have a favorable course, such as in infants presenting with benign familial neonatal epilepsy, febrile seizures simplex or acute symptomatic seizures. However, in some cases, the onset of seizures at birth or in the first months of life have a dramatic evolution with severe cerebral impairment. Seizure disorders starting in early life include the "epileptic encephalopathies", a group of conditions characterized by drug resistant seizures, delayed developmental skills, and intellective disability. This group of disorders includes early infantile epileptic encephalopathy also known as Ohtahara syndrome, early myoclonic encephalopathy, epilepsy of infancy with migrating focal seizures, infantile spasms syndrome (also known as West syndrome), severe myoclonic epilepsy in infancy (also known as Dravet syndrome) and, myoclonic encephalopathies in non-progressive disorder. Here we report on seizures manifesting in the first year of life including the neonatal period. Conditions with a benign course, and those with severe evolution are presented. At this early age, clinical identification of seizures, distinction of each of these disorders, type of treatment and prognosis is particularly challenging. The aim of this report is to present the clinical manifestations of each of these disorders and provide an updated review of the conditions associated with seizures in the first year of life.
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Affiliation(s)
- Piero Pavone
- Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, A.U.O. Vittorio Emanuele-Policlinico of Catania, Via Santa Sofia 78, 95100, Catania, Italy.
| | - Giovanni Corsello
- Department of Maternal and Child Health, University of Palermo, Palermo, Italy
| | - Martino Ruggieri
- Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, A.U.O. Vittorio Emanuele-Policlinico of Catania, Via Santa Sofia 78, 95100, Catania, Italy
| | - Silvia Marino
- University-Hospital 'Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy
| | - Simona Marino
- University-Hospital 'Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy
| | - Raffaele Falsaperla
- University-Hospital 'Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy
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Serum phenobarbitone levels in term and near-term neonates with seizures. Indian Pediatr 2016; 53:388-90. [DOI: 10.1007/s13312-016-0858-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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7
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Singhi P. Editorial. Indian J Pediatr 2014; 81:881-2. [PMID: 25103015 DOI: 10.1007/s12098-014-1546-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Accepted: 07/17/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Pratibha Singhi
- Pediatric Neurology and Neurodevelopment Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India,
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