Seizures In Preterm Neonates Research Articles

Role of Transcranial Ultrasound and Doppler Studies to Evaluate Intracranial Pathologies in Preterm and High-risk Term Neonates.

Transcranial grayscale neurosonography (NSG) and Doppler studies have major role in diagnosing neonate intracranial pathologies. The aim of the study is to evaluate the role of NSG and Doppler studies in correlation with clinical hypotonia and seizures in preterm neonates and high-risk term neonates. The prevalence of intracranial pathology is the second aim of this study. The present cross-sectional study was done in a tertiary care teaching hospital for 2 years. The study population of 120 cases comprised two groups: one group of 60 preterm neonates and the other of 60 high-risk term neonates with a history of well-defined episode of fetal distress. The NSG and Doppler findings (resistance index ≤0.62 is the optimum cutoff point for diagnosing perinatal asphyxia) are recorded. The sensitivity and specificity values for the NSG study alone, the Doppler study alone, and the combined NSG and Doppler studies are calculated. The majority (46%) of preterm neonates had presented with germinal matrix hemorrhage, whereas a majority (46%) of high-risk term neonates had presented with periventricular and subcortical cysts. Comparison of the sensitivity of NSG versus Doppler versus combined NSG and Doppler in evaluating hypotonia and seizures in preterm (P = 0.0442) and high-risk term neonates (P = 0.0399) was significant. NSG combined with the Doppler study has significantly higher sensitivity than NSG alone in both groups. The specificity of the Doppler study is also high in both groups. Thus, it is strongly recommended to include Doppler during every NSG study to increase the detection rate.

Long-Term Video Electroencephalographic Monitoring in

BackgroundDespite recognizing high seizure risk, the current consensus guidelines on evaluating seizures in preterm neonates are based on limited data. We chose to investigate the seizure risk in high-risk preterm (<30 weeks gestation) asymptomatic (without a clinical concern for seizures) infants with high-grade intraventricular hemorrhage who underwent long-term video electroencephalographic monitoring. MethodsWe performed a comprehensive retrospective review on all infants of <30-week gestational age admitted to the University of Alabama at Birmingham Regional Neonatal Intensive Care Unit from June 2018 to October 2022. We selected those patients who underwent electroencephalographic monitoring without a prior clinical concern for seizures. We recorded gender, gestational age, APGAR scores (one and five minutes), intraventricular hemorrhage (grade, age at diagnosis), and electroencephalographic monitoring (timing and duration) data. ResultsAmong 37 premature infants, six had seizures detected on electroencephalographic monitoring. All six infants had subclinical seizures. Only two of six patients had a clinical correlation (although not identified by the providers) with some of their seizures. Patients with seizures were significantly younger in chronological age (median age 6.5 days vs 9 days, P value 0.009) at the time of the electroencephalographic monitoring initiation and were more likely to have subsequent monitoring studies (P value 0.0418). ConclusionsLong-term video electroencephalographic monitoring performed after the diagnosis of high-grade intraventricular hemorrhage captured seizures in ∼16% of asymptomatic premature neonates of <30 weeks’ gestation. Patients identified to have seizures were significantly younger (chronological age) at the time of the electroencephalographic monitoring initiation and were more likely to be remonitored.

Protein S100B and Amplitude-Integrated EEG as Early Predictive Methods for Brain Injury and Seizures in Preterm Neonates

Background: Neonatal brain injury (NBI) is a serious adverse outcome in premature neonates. The most common form of neonatal brain injury (NBI) are intraventricular hemorrhage (IVH) and periventricular leukomalacia (PVL). Improved survival of preterm infants leads to short- and long-term hazards of neurological, cognitive, respiratory, digestive, renal, cardiovascular, metabolic, immune, and psychosocial disturbances. We sought to determine the levels and prognostic value of serum S100B and the role of aEEG during the first three days of life in premature neonates (&lt; 37 weeks) that later developed NBI in the form of intraventricular hemorrhage (IVH) or neonatal seizures to rule out the sensitivity and specificity of them in early detection of brain lesions in preterm neonates.&#x0D; Aim of the Study: To evaluate the role of Protein S100B as an early predictor for neonatal brain injury in preterm neonates and the predictive and prognostic value of amplitude-integrated electroencephalography for neonatal brain injury susceptibility and severity.&#x0D; Subject and Methods: This study was carried out on 50 preterm neonate (less than 37 weeks GA) who were divided according to presence or absence of brain injury into case and control groups. They were admitted in Neonatal Intensive Care Unit (NICU) of Tanta University Hospital during the period from March 2021 to March 2022.serum S100B at (Day 1 and Day 3), serial trans-cranial sonar and aEEG were done for all patients.&#x0D; Results: Neonates with NBI, had significantly higher S100B concentration during the first three days of life, its level was higher in the third day than the first day, the cut-off value &gt;810.4 ng/ml serum S100B performed a sensitivity of 72.7%and a specificity of 71.4% to predict adverse neonatal outcome. 60% neonates had normal aEEG and 40% had abnormal aEEG.72.7% of neonates with NBI had abnormal aEEG interpretation. There was a significant relationship between the electrografic seizures on aEEG and occurrence of clinical seizures as 96.7% of neonates who had abnormal aEEG suffered of clinical convulsion.&#x0D; Conclusion: Protein S100B has a good predictive value regarding NBI in premature neonates and aEEG has a great role in monitoring neonatal brain function and early detection of neonatal seizures.

Electrographic Seizures in Preterm Neonates in the Neonatal Intensive Care Unit.

Characterize clinical and electroencephalography (EEG) characteristics of preterm neonates undergoing continuous EEG in the neonatal intensive care unit. Retrospective study of preterm neonates born less than 37 weeks' gestational age undergoing continuous EEG in the neonatal intensive care unit at Boston Children's Hospital over a 2-year period. Fifty-two preterms (46% male) had a mean gestational age of 32.8 weeks (standard deviation = 4.17). Seizures were detected in 12/52 (23%), with EEG seizures detected in 4/12 (33%). The median time from EEG to the first seizure was 0.5 hours (interquartile range 0.24-4). Factors associated with seizures were male gender (odds ratio = 4.65 [95% confidence interval = 1.02-21.24], P = .047) and lack of EEG state change (odds ratio = 0.043 [95% confidence interval = 0.005-0.377], P = .04). Twenty-three percent of preterms undergoing continuous EEG had EEG seizures or electrographic seizures with no clear clinical correlate. This confirms recent American Clinical Neurophysiology Society guidelines suggesting that preterm neonates are at high risk for seizures.

Retraction Note to: Low Dose Lidocaine for Refractory Seizures in Preterm Neonates

Retraction Note to: Low Dose Lidocaine for Refractory Seizures in Preterm Neonates

RETRACTED ARTICLE: Low Dose Lidocaine for Refractory Seizures in Preterm Neonates

RETRACTED ARTICLE: Low Dose Lidocaine for Refractory Seizures in Preterm Neonates