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Prediction of Future Epilepsy in Neonates With Hypoxic-Ischemic Encephalopathy Who Received Selective Head Cooling.

TitlePrediction of Future Epilepsy in Neonates With Hypoxic-Ischemic Encephalopathy Who Received Selective Head Cooling.
Publication TypeJournal Article
Year of Publication2017
AuthorsMcDonough TL, Paolicchi JM, Heier LA, Das N, Engel M, Perlman JM, Grinspan ZM
JournalJ Child Neurol
Volume32
Issue7
Pagination630-637
Date Published2017 06
ISSN1708-8283
KeywordsBrain, Child, Preschool, Electroencephalography, Epilepsy, Female, Head, Humans, Hypothermia, Induced, Hypoxia-Ischemia, Brain, Infant, Infant, Newborn, Magnetic Resonance Imaging, Male, Retrospective Studies, Treatment Outcome
Abstract

Epilepsy outcomes after therapeutic hypothermia for neonates with hypoxic-ischemic encephalopathy are understudied. The authors used multivariable logistic regression to predict epilepsy in neonates after selective head cooling. Sensitivity analyses used magnetic resonance imaging (MRI) and electroencephalogram (EEG) interpretations by different clinicians. Fifty neonates had 2-year follow-up. Nine developed epilepsy. Predictors included pH ≤6.8 on day of birth (adjusted odds ratio [OR] 19 [95% confidence interval (CI) 1-371]), burst suppression on EEG on day 4 (8.2 [1.3-59]), and MRI deep gray matter injury (OR 33 [2.4-460]). These factors stratify neonates into low (0-1 factors; 3% [0%-14%] risk), medium (2 factors; 56% [21%-86%] risk), and high-risk groups (3 factors; 100% [29%-100%] risk) for epilepsy. The stratification was robust to varying clinical interpretations of the MRI and EEG. Neonates with hypoxic-ischemic encephalopathy who undergo selective head cooling appear at risk of epilepsy if they have 2 to 3 identified factors. If validated, this rule may help counsel families and identify children for close clinical follow-up.

DOI10.1177/0883073817698628
Alternate JournalJ. Child Neurol.
PubMed ID28359187
Category: 
Faculty Publication