الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
We conducted a longitudinal prospective cohort study on 35 full term infants developed clinical or electrical seizures in neonatal period with subsequent neurodevelopmental measures were assessed at consecutive visits till age of 18 months, in addition 29 healthy infants of matched age and sex were assessed at same period. Our cohort showed that the most common etiologies of seizure are HIE (53%), CNS infection (31%), ICH and stroke (26%) and about 38 % of cases had more than one etiology. All subtle and myoclonic seizures were noticed in infants with HIE, while those with stroke and CNS infection developed focal/multifocal clonic seizures and those with metabolic/genetic causes developed tonic and tonic-clonic events. Among studied cases, at age of 18 months the rate of CP was 43%, mortality rate was 29% and the incidence of overall epilepsy 64.6% in all studied infants, in addition, GDD was (44%, 66%) in infants assessed by BSID and Griffiths III tests respectively and (25%, 17%) for only one domain. Survival distributions (time to death) were significant earlier in infants born with complicated vaginal mode, required initial resuscitation and advanced care (MV and HFOV), developed seizures within 1st DoL with special characteristics (as exceeding 6 days with flat or low voltage aEEG background, more than two AEDs were prescribed for optimum control and also were prescribed on their discharge plan) and also those exceeded 19 days admission in NICU. Over and above, the requirement of MV and HFOV, lack of therapeutic hypothermia, low fifth minute Apgar scores, poor response to the treatment, AEDs prior to discharge and high SB are predictive risk factors for early occurrence future epilepsy. Moreover, abnormal (BSID and Griffiths) motor subscales were largely correlated to multiple attacks of seizures, low 5th min APGAR score and AEDs prior to discharge with selective subsequent continuation of post-neonatal epilepsy. Rates of developmental impairment were (cognitive 30% vs. 69%), (language 50% vs. 58%), (motor 58% vs. 66%) in infants assessed by both BSID and Griffiths at 18 months respectively, keeping the concern that the Bayley-III may tend to underestimate some cases of abnormal outcomes whom picked up by Griffiths. We found a statistically significant interaction effect of group and time on developmental age and composite score of BSID subscales, DQ of Griffiths III and growth parameters among studied groups. There was a significant absolute agreement of moderate strength (ICC ranging from 0.5 to 0.75) in our cohort between Bayley and Griffiths tests in all 3 subscales (motor, cognitive and language) except for language subscale at 3 months; poor strength of agreement (intra-class correlation <0.5) throughout the whole study period. To conclude, occurrence of seizures in neonatal period had its unique signature on long-term morbidity. Early death, epilepsy and abnormal motor domain in later life could be predicted from the 1st days of birth though low APGAR score, frequency and duration of seizures, EEG background and the need for ASM on discharge. Furthermore, close follow-up visits at dedicated neurodevelopmental assessment clinics using standardized overall developmental assessment tools is essential for any newborn who exposed to adverse brain events aiming for early referral and intervention if needed.