Recent Outcomes Of Unexplained Seizure In The Neonatal Period:A Retrospective Study Of Clinical Features

Objective: To explore the relations between characteristics of seizure,electroencephalogram(EEG)changes and recent outcomes of patients with unexplained seizure in the neonatal period,which may provide evidence for early assessment of prognosis.Methods: Sixty cases of unexplained seizure in the neonatal period admitted to the Department of Neonatology in Shengjing Hospital of China Medical University from January 2014 to June 2019,were followed-up at the age of more than 6 months.According to the recent outcomes(recurrent seizures during non-neonatal period and the development when followed-up),the patients were divided into favorable recent outcome group(44 cases)and poor recent outcome group(16 cases).The demographic data,characteristics of seizure and EEG changes in the neonatal period were analyzed retrospectively.Results: There was no significant difference in gender,gestational age,birth weight,onset of first seizure,type of seizure,duration of seizure,and interval of seizures between two groups(P>0.05).Eleven cases with recurrent seizure after neonatal period had significantly more dysplasia than the 49 cases that without recurrent seizures(54.5% vs.10.2%,P<0.05).There were 33 cases in favorable recent outcome group and 13 cases in poor recent outcome group that finished ambulatory electroencephalogram(AEEG)and/or video electroencephalogram(VEEG).Compared with patients with favorable recent outcomes,those with poor recent outcomes had significantly more EEG changes with paroxysmal abnormal changes and paroxysmal abnormal changes combined with abnormal background activity(69.2% vs.30.3%,38.5% vs.9.1%,P<0.05).Compared with patients without recurrent seizure,those with recurrent seizure had significantly more abnormal EEG changes,EEG changes with paroxysmal abnormal changes and with paroxysmal abnormal changes combined with abnormal background activity(100.0% vs.64.9%,88.9% vs.29.7%,44.4% vs.10.8%,P<0.05).Compared with patients with normal development,those with dysplasia had significantly more EEG changes with paroxysmal abnormal changes combined with abnormal background activity(44.4% vs.10.8%,P<0.05).Conclusion: The recent outcomes of unexplained seizure in the neonatal period may be related with the EEG changes,but not gender,gestational age,birth weight,characteristics of seizure.The patients whose EEG had paroxysmal abnormal changes,or combined abnormal background activity were more likely to get poor recent outcomes,like recurrent seizures and/or dysplasia after neonatal period.