Postneonatal Epilepsy and Psychomotor Developmental Retardation Risk Factors in Term Neonatal Convulsions Without Hypoxic Ischemic Encephalopathy

Abstract

Objective: Neonatal convulsions may be an early sign of brain injury and the presence of convulsions in the neonatal period has been associated with long-term sequelaes such as mental retardation, postnatal epilepsy and death. We aimed to determine associations of etiological factors with neurodevelopment and postneonatal epilepsy and evaluate the risk factors in newborns with neonatal convulsions that were not related to hypoxic-ischemic encephalopathy. Material and Methods: This study included full-term infants who were born between January 2010 and December 2014 and had neonatal convulsion history, had no history of hypoxic-ischemic encephalopathy and were followed for at least 1 year at our neurology clinic. Results: Forty-nine patients were included to the study. Among the identified etiologies on first clinical visit, hypoglycemia was the most common cause which was presented in 11 (40.74%; 11/27 patients) patients. During follow-up, 22.4% (n=11) of patients developed postneonatal epilepsy. In 4 of 7 patients with abnormal Bayley II test results, epilepsy developed in the follow-up. The risk for development of postneonatal epilepsy was significantly associated with abnormal neurological findings, such as cerebral palsy or significant delays in developmental stages; being not benefited from acute treatment and follow-up abnormal EEG findings of the patients. Conclusion: Hypoglycemia should be primarily investigated and treated in term neonatal seizures without hypoxia. Abnormal neurological findings, being not benefited from the acute treatment and follow-up EEG findings were associated with developing epilepsy. In the literature, most of the studies were limited due to short follow-up periods. More information about prognostic factors in neonatal convulsions and the occurrence of postneonatal epilepsy is needed.