Neonatal seizures are the most common neurological event in newborns, showing higher prevalence in preterm than in full-term infants. In the majority of cases they represent acute symptomatic phenomena, the main etiologies being intraventricular haemorrhage, hypoxic-ischemic encephalopathy, central nervous system infections and transient metabolic derangements.Current definition of neonatal seizures requires detection of paroxysmal EEG-changes, and in preterm newborns the incidence of electrographic-only seizures seems to be particularly high, further stressing the crucial role of electroencephalogram monitoring in this population. Imaging work-up includes an integration of serial cranial ultrasound and brain magnetic resonance at term-equivalent age. Unfavourable outcomes following seizures in preterm infants include death, neurodevelopmental impairment, epilepsy, cerebral palsy, hearing and visual impairment. As experimental evidence suggests a detrimental role of seizures per se in determining subsequent outcome, they should be promptly treated with the aim to reduce seizure burden and long-term disabilities. However, neonatal seizures show low response to conventional anticonvulsant drugs, and this is even more evident in preterm newborns, due to intrinsic developmental factors. As a consequence, as literature does not provide any specific guidelines, due to the lack of robust evidence, off-label medications are often administered in clinical practice.

Symptomatic seizures in preterm newborns: a review on clinical features and prognosis / Spagnoli, Carlotta; Falsaperla, Raffaele; Deolmi, Michela; Corsello, Giovanni; Pisani, Francesco. - In: THE ITALIAN JOURNAL OF PEDIATRICS. - ISSN 1824-7288. - 44:1(2018), p. 115. [10.1186/s13052-018-0573-y]

Symptomatic seizures in preterm newborns: a review on clinical features and prognosis

Spagnoli, Carlotta;DEOLMI, MICHELA;Pisani, Francesco
2018

Abstract

Neonatal seizures are the most common neurological event in newborns, showing higher prevalence in preterm than in full-term infants. In the majority of cases they represent acute symptomatic phenomena, the main etiologies being intraventricular haemorrhage, hypoxic-ischemic encephalopathy, central nervous system infections and transient metabolic derangements.Current definition of neonatal seizures requires detection of paroxysmal EEG-changes, and in preterm newborns the incidence of electrographic-only seizures seems to be particularly high, further stressing the crucial role of electroencephalogram monitoring in this population. Imaging work-up includes an integration of serial cranial ultrasound and brain magnetic resonance at term-equivalent age. Unfavourable outcomes following seizures in preterm infants include death, neurodevelopmental impairment, epilepsy, cerebral palsy, hearing and visual impairment. As experimental evidence suggests a detrimental role of seizures per se in determining subsequent outcome, they should be promptly treated with the aim to reduce seizure burden and long-term disabilities. However, neonatal seizures show low response to conventional anticonvulsant drugs, and this is even more evident in preterm newborns, due to intrinsic developmental factors. As a consequence, as literature does not provide any specific guidelines, due to the lack of robust evidence, off-label medications are often administered in clinical practice.
Symptomatic seizures in preterm newborns: a review on clinical features and prognosis / Spagnoli, Carlotta; Falsaperla, Raffaele; Deolmi, Michela; Corsello, Giovanni; Pisani, Francesco. - In: THE ITALIAN JOURNAL OF PEDIATRICS. - ISSN 1824-7288. - 44:1(2018), p. 115. [10.1186/s13052-018-0573-y]
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11381/2852543
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