Risk factors for epilepsy in children with neonatal encephalopathy

Pediatr Res. 2011 Nov;70(5):535-40. doi: 10.1203/PDR.0b013e31822f24c7.

Abstract

We examined neonatal predictors of epilepsy in term newborns with neonatal encephalopathy (NE) by studying children enrolled in a longitudinal, single center cohort study. Clinical data were obtained through chart review, and MRI was performed in the neonatal period. We administered a seizure questionnaire to parents of children aged ≥ 12 mo (range, 12 mo to 16.5 y) to determine the outcome of epilepsy. The association between clinical predictors and time to onset of epilepsy was assessed using Cox proportional hazards regression. Thirteen of 129 children developed epilepsy: all had neonatal seizures and brain injury on neonatal MRI. Of the newborns with neonatal seizures, 25% (15.8/1000 person-years) developed epilepsy, with the highest hazard ratios (HRs) in the newborns with status epilepticus (HR, 35.8; 95% CI, 6.5-196.5). Children with severe or near-total brain injury were more likely to develop epilepsy compared with those with only mild or moderate injury (HR, 5.5; 95% CI, 1.8-16.8). In a multivariable analysis adjusting for degree of encephalopathy and severe/near-total brain injury, status epilepticus was independently associated with epilepsy. These data add to information regarding epilepsy pathogenesis and further aid clinicians to counsel parents regarding the likelihood that a newborn with NE will develop epilepsy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • California
  • Child
  • Child, Preschool
  • Cohort Studies
  • Epilepsy / epidemiology*
  • Epilepsy / etiology*
  • Humans
  • Hypoxia-Ischemia, Brain / complications*
  • Hypoxia-Ischemia, Brain / epidemiology
  • Incidence
  • Infant
  • Infant, Newborn
  • Longitudinal Studies
  • Magnetic Resonance Imaging
  • Proportional Hazards Models
  • Risk Factors
  • Status Epilepticus / complications*
  • Surveys and Questionnaires