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Neonatal Med > Volume 20(4); 2013 > Article
Neonatal Medicine 2013;20(4):428-437.
DOI: https://doi.org/10.5385/nm.2013.20.4.428    Published online January 15, 2014.
Seizure Scoring System and Neurodevelopmental Outcomes in Very Low Birth Weight Infants with Neonatal Seizures.
Hyun Jin Kim, Byong Sop Lee, Mi Sun Yum, Hee Jin Jang, Sung Hee Oh, Hyun Jung Do, Sung Hoon Chung, Tae Sung Ko, Ellen Ai Rhan Kim, Ki Soo Kim
Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea. mdleebs@amc.seoul.kr
Abstract
PURPOSE
To evaluate the utility of seizure scoring system in the prediction of neurodevelopmental outcomes in very low birth weight (VLBW) infants who presented with neonatal seizures.
METHODS
A retrospective review was performed in VLBW infants who were treated with antiepileptic drugs (AED) for the control of neonatal seizures. A total of 25 infants who survived and were followed-up for at least 2 years of age were included. A new seizure scoring system (the composite score 0-8) was constructed by choosing the following variables: onset, response to the AED, presence of status epilepticus, seizure types and EEG findings including background activity and epileptiform discharges. Neurodevelopmental outcomes were graded from 1 to 5 based on the developmental status and the neurologic abnormalities assessed at 18 to 24 months of postconceptional age. Risk factor analyses for predicting unfavorable outcomes (grade 3-5) versus favorable outcomes (grade 1-2) were performed.
RESULTS
Compared to favorable outcome group (n=11), unfavorable outcome group (n=14) had higher incidence of subtle or generalized tonic-type seizures, the abnormal EEG background activity and poor response to AED. The composite seizure score was significantly higher in the unfavorable outcome group (3.2+/-0.7) than in the favorable outcome group (1.2+/-1.2) and it significantly correlated with the neurodevelopmental grading (P<0.001). In multivariate analysis, abnormal MRI findings at term and the composite seizure score were significant risk factors for unfavorable outcomes.
CONCLUSION
In VLBW infants with neonatal seizure, the proposed seizure scoring system was a simple and useful predictor of long-term neurologic outcomes.
Key Words: Neonatal seizure, Seizure scoring system, Very low birth weight infant, Neurodevelopmental outcome


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