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Childs Nerv Syst. 2019 Sep;35(9):1571-1578. doi: 10.1007/s00381-019-04286-x. Epub 2019 Jul 5.

Neurodevelopmental outcomes at 9-14 months gestational age after treatment of neonatal seizures due to brain injury.

Author information

1
Division of Pediatric Neurology, Department of Pediatrics, University of Florida College of Medicine, 1600 SW Archer Rd, Gainesville, FL, 32610, USA. suman.ghosh@ufl.edu.
2
College of Liberal Arts and Sciences, University of Florida College of Medicine, Gainesville, FL, USA.
3
University of Florida Rehabilitation for Kids, Gainesville, FL, USA.
4
Department of Biostatistics, University of Florida College of Medicine, Gainesville, FL, USA.
5
Division of Neonatology, Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL, USA.
6
Division of Pediatric Neurology, Department of Pediatrics, University of Florida College of Medicine, 1600 SW Archer Rd, Gainesville, FL, 32610, USA.

Abstract

PURPOSE:

Infants with brain injury are susceptible to developmental delays. Survivors of neonatal seizures are at risk for developmental delay, epilepsy, and further neurological comorbidities. Despite advances in neonatal critical care, the prevalence of adverse long-term outcomes and seizure recurrence remains unchanged. Our goal is to determine if early treatment of neonatal seizures with phenobarbital or levetiracetam is associated with worse neurodevelopmental outcomes in brain-injured infants.

METHODS:

We conducted a retrospective cohort study of 119 infants admitted between 2013 and 2017 who were at risk for developmental delay and assessed in our clinic. We compared brain injury infants with neonatal seizures to brain injury infants without neonatal seizures using Bayley scores (BSID III) at 9-14 months gestational age. A comparison of Bayley scores between those exposed to phenobarbital and levetiracetam was conducted.

RESULTS:

Twenty-two children with neonatal seizures scored lower than 53 children without seizures in all domains with significant values in composite scores for cognitive function (p = 0.003) and language (p = 0.031). We found no difference in scores at 9-14 months between infants exposed to phenobarbital versus levetiracetam.

CONCLUSIONS:

Our results suggest that in infants with brain injury, the occurrence of neonatal seizures has an adverse effect on neurodevelopmental outcomes. The choice of antiseizure medication may not play a significant role in their outcomes.

KEYWORDS:

Bayley Scale; Developmental delay; Levetiracetam; Phenobarbital

PMID:
31278442
DOI:
10.1007/s00381-019-04286-x

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