EARLY ANATOMICAL INJURY PATTERNS PREDICT POST-NEONATAL EPILEPSY IN INFANTS TREATED WITH SELECTIVE HEAD COOLING FOR NEONATAL HYPOXIC ISCHEMIC INJURY
Abstract number :
1.222
Submission category :
4. Clinical Epilepsy
Year :
2014
Submission ID :
1867927
Source :
www.aesnet.org
Presentation date :
12/6/2014 12:00:00 AM
Published date :
Sep 29, 2014, 05:33 AM
Authors :
Daeun Jung, Charu Venkatesan, Douglas Nordli, David Ritacco and Sookyong Koh
Rationale: Newborns treated with hypothermia for hypoxic ischemic injury (HIE) are at increased risk for catastrophic infantile epilepsies. We questioned whether anatomical patterns of injury on MRI correlated with post-neonatal epilepsy. Methods: We reviewed records for all infants born and treated with selective head cooling for HIE between August 2008 and May 2013 at Northwestern University. Results: Overall, outcome was favorable for our cohort of 73 with mean follow-up of 41 (± 7) months. All had brain MRI on day 4 or 5 of life and EEGs beyond newborn period. The majority (48/73, 66%) had no seizure recurrence, while 13 (18%) developed post-neonatal epilepsy including 8 with infantile spasms (IS). Twelve infants (16%) died. The most common MRI findings were diffuse brain injury involving both cortical and subcortical gray matter (basal ganglia and/or thalamus) in 26 (35%) followed by cortical injury alone in 18 (25%) and normal MRI in 16 (22%). Extensive brain injury including brain stem (BS) occurred in 13 and was highly predictive of unfavorable outcome (death or IS in all vs. 7/60 in those without BS injury, p<
Clinical Epilepsy