Research On Long Term Neurological Prognosis And Influencing Factors Of Neonatal Seizure

Objective: Long term neurological prognosis of neonatal seizure and the relevant factor affecting long term neurological prognosis of newborn were discussed in this paper.Which was intended to provide relevant theoretical basis for diagnosing neonatal seizure in early clinic,evaluating the outcome of long term neurodevelopment as soon,early positive intervention treatment,reducing cerebral injury,and improving long term neurological prognosis.Methods: Gathering the diagnosed neonatal seizure hospitalization in Children’s Hospital of Chongqing Medical University during January 2010 to December 2017.482 cases were hit,in which only 252 cases were clinical seizures and 230 cases were clinical-electrical convulsions.230 cases with clinical-electrical convulsions were followed-up 12 months at least.The follow-ups were conducted by informing the children’s parents by telephone to carry the children to take reexamination and overall assessment,otherwise,achieving the children’s conditions or examination results provided by their parents in telephone.The sample capability was 173,which were divided into group of favorable prognosis and group of poor prognosis.Clinical data of the patients were gathered,including general situation,etiology,auxiliary examinations and treatment.The factors affecting long term neurological prognosis of neonatal seizures were determined by single factor analysis and multi-factor binary Logistic regression analysis.Results: 173 patients were followed-up in this study.The group size of favorable prognosis group was 77(44.51%)and group size of poor prognosis was 96(55.49%).The group of poor prognosis included 12 cases with epilepsy(12.5%),8 cases with cerebral palsy(8.33%),6 cases with died(6.25%),1 case with blindness(1.04%),3 cases with hearing loss(3.13%),9 cases(9.38%)with learning disabilities,18 cases with language retardation,(18.75%),14 cases(14.58%)with motor delay,2 cases(2.08%)lonely spectrum disorders,23 cases(23.96%)with more than one kinds of complications(which is common for cerebral palsy with epilepsy).The prognosis factors of two groups were determined by single factor analysis.The results show that delivery way,10 min Apgar score,SE,brain malformations,neonatal asphyxia,head MRI,v EEG and aEEG,anticonvulsive effect,anti-seizure treatment duration were statistically significant factors.Furthermore,the results of Logistic regression imply that SE,neonatal asphyxia,abnormal head MRI,abnormal vEEG,severely abnormal aEEG,long anti-seizure treatment duration were independent factors associated with poor prognosis.Conclusion: The incidence of long-term neurological prognosis in this study was 55.49%,the most common poor outcomes were sports and language development delay(33.33%)which with mortality rate of 6.25%.Cerebral palsy along with epilepsy was the high risk factor of long term neurological prognosis in neonatal seizure,which should pay great attention in clinic.Early recovery and regulated antiepileptic therapy may reduce severe sequela.SE,neonatal asphyxia,abnormal head MRI,abnormal vEEG and severely abnormal aEEG,long anti-seizure treatment duration were independent risk factors of long term neurological prognosis.High incidence of long term neurological with poor prognosis in neonatal seizures threats life quality of children and increases the burden of family and society.Which can be alleviated by early detection in clinic,early intervention,regulated treatment and regular following-up.