Neonatal neuroimaging and neurophysiology predict infantile onset epilepsy after perinatal hypoxic ischemic encephalopathy

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http://hdl.handle.net/10138/332223

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Nevalainen , P , Metsäranta , M , Toiviainen-Salo , S , Marchi , V , Mikkonen , K , Vanhatalo , S & Lauronen , L 2020 , ' Neonatal neuroimaging and neurophysiology predict infantile onset epilepsy after perinatal hypoxic ischemic encephalopathy ' , Seizure - European Journal of Epilepsy , vol. 80 , pp. 249-256 . https://doi.org/10.1016/j.seizure.2020.07.002

Title: Neonatal neuroimaging and neurophysiology predict infantile onset epilepsy after perinatal hypoxic ischemic encephalopathy
Author: Nevalainen, Päivi; Metsäranta, Marjo; Toiviainen-Salo, Sanna; Marchi, Viviana; Mikkonen, Kirsi; Vanhatalo, Sampsa; Lauronen, Leena
Contributor: University of Helsinki, HUS Medical Imaging Center
University of Helsinki, HUS Children and Adolescents
University of Helsinki, HUS Medical Imaging Center
University of Helsinki, Lastenneurologian yksikkö
University of Helsinki, HUS Medical Imaging Center
University of Helsinki, HUS Medical Imaging Center
Date: 2020-08
Language: eng
Number of pages: 8
Belongs to series: Seizure - European Journal of Epilepsy
ISSN: 1059-1311
URI: http://hdl.handle.net/10138/332223
Abstract: Purpose: To evaluate the accuracy of hypoxic ischemic encephalopathy (HIE) grade, and neonatal neurophysiological and neuroimaging measures for predicting development of infantile spasms syndrome (IS) or other postneonatal, infantile onset epilepsy after perinatal HIE. Methods: We examined a population-based cohort of 92 consequent infants with moderate-to-severe HIE. The HIE grade and neonatal neuroimaging (MRI) and neurophysiology (EEG and somatosensory evoked potentials, SEPs) findings were compared to the development of IS or other epilepsy within the first year of life. Results: Out of 74 surviving infants with follow-up information, five developed IS and one developed a focal onset epilepsy. They all had recovered from severe HIE. All survivors with inactive neonatal EEG (recorded within the first few postnatal days, n = 4) or the most severe type of brain injury in MRI (n = 3) developed epilepsy (positive predictive value, PPV 100 %). Bilaterally absent SEPs had 100 % sensitivity and 75 % PPV for epilepsy. A combination of absent SEPs and a poor MRI finding (combined deep and cortical gray matter injury) resulted in higher PPV (86 %) without lowering sensitivity (100 %). Follow-up EEGs showed recurrent epileptiform activity already between 1- and 2-months age in those that developed epilepsy, distinguishing them from those surviving without epilepsy. Conclusions: Poor neonatal neuroimaging and neurophysiological findings provide accurate prediction for development of infantile onset epilepsy after HIE. Of the neonates with severe HIE, the ones with severe neonatal MRI and neurophysiological abnormalities need frequent follow-up, including repeated EEGs, for early detection of IS.
Subject: Infantile spasms syndrome (IS)
Perinatal hypoxic ischemic encephalopathy
Electroencephalography (EEG)
Somatosensory evoked potentials (SEPs)
Magnetic resonance imaging (MRI)
WEST-SYNDROME
SYSTEMIC HYPOTHERMIA
ASPHYXIATED INFANTS
SPASMS
EVOLUTION
AEEG
HYPSARRHYTHMIA
NEWBORNS
RISK
TERM
3112 Neurosciences
3124 Neurology and psychiatry
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