Neonatal Seizures and Associated Neurobehavioral Profiles in Preschool Age Children

Abstract

Listen

Translate article

BackgroundNeonatal seizures are common with acute brain injury. Up to 25% of survivors develop post-neonatal epilepsy. We hypothesized post-neonatal epilepsy diagnosed by age 24-months would increase risk for early markers of neurobehavioral disorders than acute provoked neonatal seizures alone. MethodsNeonates with acute provoked seizures born 7/2015-3/2018 enrolled at 9 Neonatal Seizure Registry sites. Composite scores from parent-completed standardized ratings assessed Adaptive, Social, Externalizing, Internalizing, Self-Regulation, and Sensory Seeking domains. Linear regression demonstrated relationships between composite scores for children who developed post-neonatal epilepsy compared with those who did not. Results were adjusted for seizure etiology, sex, gestational age, and cerebral palsy (CP) severity. Results151 children (n=20, 13% with post-neonatal epilepsy), 4.1 years median age participated. Children with epilepsy had impaired adaptive (Cohen’s d = 1.62, p<.0001), social (Cohen’s d = 0.86, p=0.004), and executive functioning (Cohen’s d = 0.56, p=0.06) compared to children without epilepsy. Mean neurobehavioral scores for children without epilepsy were within normative average range. Risk for impairment among children with epilepsy persisted after adjusting for neonatal seizure etiology, sex, and gestational age, but not when adjusting for CP severity. ConclusionsIn this cohort of survivors of provoked neonatal seizures, there was higher incidence of adverse neurobehavioral outcomes among preschool children diagnosed with post-neonatal epilepsy compared with those without epilepsy. CP severity was associated with greater impairment, results also suggest that epilepsy is an independent predictor of adaptive functioning. Children with post-neonatal epilepsy should be screened for neurobehavioral problems to facilitate early identification and developmental support.