SIGNIFICANCE OF SEIZURES IN VERY LOW‐BIRTHWEIGHT INFANTS

Of 506 very low‐birthweight (VLBW) infants, the authors review data on 67 identified as having seizures. 29 survivors with seizures and 305 without were followed up at the ages of one, two and five years: statistical significance of psychological and mental impairment was evaluated. Impairment was higher in the seizure group at 66 per cent (15 per cent in non‐seizure group) and 43 per cent of these were considered to be severely impaired. Infants with seizures occurring for more than seven days and lasting for more than five minutes had the poorest outcome, and infants with late onset had the best outcome. Analysis showed that 40 per cent of seizures were caused by birth asphyxia, and these were strongly prognostic, correlating with mortality and impairment rates. 60 per cent of the infants who died had the same cause for both their seizures and death, and for 57 per cent of these the cause was perinatal asphyxia. The poor outlook for the VLBW infants suggests that the seizures themselves are a seríous neurological insult.

[1]  R P Hirsch,et al.  Outcome in neonates with convulsions treated in an intensive care unit , 1983, Annals of neurology.

[2]  J. P. Bahr,et al.  A scoring system to predict outcome following neonatal seizures. , 1981, The Journal of pediatrics.

[3]  C. Dreyfus-Brisac,et al.  Convulsions du nouveau-ne. Aspects clinique, electrographique, etiopathogenique et pronostique , 1981 .

[4]  J M Freeman,et al.  Neonatal seizures. I. Correlation of prenatal and perinatal events with outcomes. , 1982, Pediatrics.

[5]  Harvey B. Sarnat,et al.  NEONATAL ENCEPHALOPATHY FOLLOWING FETAL DISTRESS , 1977 .

[6]  B. Meldrum Physiological Changes During Prolonged Seizures and Epileptic Brain Damage , 1978, Neuropadiatrie.

[7]  C. Wasterlain,et al.  Breakdown of brain polysomes in status epilepticus. , 1972, Brain research.

[8]  J. Volpe,et al.  Seizures in the preterm infant: effects on cerebral blood flow velocity, intracranial pressure, and arterial blood pressure. , 1983, The Journal of pediatrics.

[9]  C. Wasterlain Inhibition of cerebral protein synthesis by epileptic seizures without motor manifestations , 1974, Neurology.

[10]  Cerebral energy metabolism and the regulation of cerebral blood flow. , 1973, Transactions of the American Neurological Association.

[11]  H. Sarnat,et al.  Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study. , 1976, Archives of neurology.

[12]  F. Plum,et al.  Vulnerability of developing rat brain to electroconvulsive seizures. , 1973, Archives of neurology.

[13]  T. A. Knauss,et al.  Seizures in a Neonatal Intensive Care Unit , 1977 .

[14]  P. Bray,et al.  Significance of seizures in infants weighing less than 2,500 grams. , 1977, Archives of neurology.

[15]  H. Goldberg Neonatal convulsions--a 10 year review. , 1983, Archives of disease in childhood.