Long-term neurological outcome of term-born children treated with two or more anti-epileptic drugs during the neonatal period
Long-term neurological outcome of term-born children treated with two or more anti-epileptic drugs during the neonatal period
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DOI：
10.1016/j.earlhumdev.2011.06.012
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发表时间：
2012-01-01
影响因子：
2.5
通讯作者：
Bos, Arend F.
中科院分区：
文献类型：
--
作者：
van der Heide, Mariska J.;Roze, Elise;Bos, Arend F.
背景资料：新生儿癫痫发作可能会持续，尽管治疗与多种抗癫痫药物（AEDs）。目的：为了确定在条款出生的婴儿癫痫发作，需要两个或更多的AEDs，治疗效果和/或潜在的障碍是否与神经outcome.Design/方法：我们包括82名儿童（出生于1998年至2006年）治疗新生儿癫痫发作。我们记录了死亡率、癫痫发作的病因、所需的AED数量、癫痫发作控制的实现和振幅积分EEG（aEEG）背景模式。随访包括适合年龄的神经系统检查。存活的儿童被归类为正常，有轻度神经系统异常，或脑瘫（CP）。结果：47名婴儿（57%）有癫痫持续状态。AED的数量与神经系统结局无关。使用三种或四种AED而不是两种AED的治疗显示出不良结局风险增加的趋势，即，死亡或CP，比值比（OR）2.74; 95%置信区间（CI）0.98-7.69; P= 0.055。癫痫控制失败增加了不良结局的风险，OR 6.77; 95%-CI 1.42-32.82，P= 0.016。持续严重异常的aEEG背景模式也增加了这种风险。OR 3.19; 95%-CI 1.90-5.36; P
Background: Neonatal seizures may persist despite treatment with multiple anti-epileptic drugs (AEDs).Objective: To determine in term-born infants with seizures that required two or more AEDs, whether treatment efficacy and/or the underlying disorder were related to neurological outcome.Design/methods: We included 82 children (born 1998-2006) treated for neonatal seizures. We recorded mortality, aetiology of seizures, the number of AEDs required, achievement of seizure control, and amplitude-integrated-EEG (aEEG) background patterns. Follow-up consisted of an age-adequate neurological examination. Surviving children were classified as normal, having mild neurological abnormalities, or cerebral palsy (CP).Results: Forty-seven infants (57%) had status epilepticus. The number of AEDs was not related to neurological outcome. Treatment with three or four AEDs as opposed to two showed a trend towards an increased risk of a poor outcome, i.e., death or CP, odds ratio (OR) 2.74; 95% confidence interval (CI) 0.98-7.69; P=.055. Failure to achieve seizure control increased the risk of poor outcome, OR 6.77; 95%-CI 1.42-32.82, P=.016. Persistently severely abnormal aEEG background patterns also increased this risk. OR 3.19; 95%-CI 1.90-5.36; P