Risk factors for epilepsy in children with neonatal encephalopathy.
Risk factors for epilepsy in children with neonatal encephalopathy.
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DOI：
10.1203/pdr.0b013e31822f24c7
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发表时间：
2011-11
影响因子：
3.6
通讯作者：
Ferriero DM
中科院分区：
文献类型：
--
作者：
Glass HC;Hong KJ;Rogers EE;Jeremy RJ;Bonifacio SL;Sullivan JE;Barkovich AJ;Ferriero DM
通过一项纵向的单中心队列研究，我们研究了患有新生儿脑病(NE)的足月新生儿癫痫的预测因素。临床资料通过复习图表获得，并在新生儿期进行MRI检查。我们对12个月大(12个月-16.5岁)≥儿童的父母进行了癫痫发作问卷调查，以确定癫痫的结局。临床预测因素与癫痫发病时间之间的关联通过COX比例风险回归进行评估。129名儿童中有13名出现癫痫：所有儿童在新生儿MRI上都有新生儿癫痫发作和脑损伤。在有新生儿癫痫发作的新生儿中，有25%(15.8/1000人年)发生癫痫，其中癫痫持续状态新生儿的危险比(HR)最高(HR35.8，95%CI6.5~196.5)。重度或接近全脑损伤的儿童比仅有轻度或中度损伤的儿童更容易发生癫痫(HR 5.5，95%CI 1.8~16.8)。在调整了脑病程度和严重/几乎全部脑损伤的多变量分析中，癫痫持续状态与癫痫独立相关。这些数据增加了有关癫痫发病机制的信息，并进一步帮助临床医生就患有NE的新生儿发生癫痫的可能性向父母提供建议。
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 months (range 12 months–16.5 years) 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 (HR) 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.