| Seizures and magnetic resonance imaging-detected brain injury in newborns cooled for hypoxic-ischemic encephalopathy. | |
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MedLine Citation:
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PMID: 21839470 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To describe the association between electrographically detected seizures and brain injury evaluated by magnetic resonance imaging in newborns treated with hypothermia. STUDY DESIGN: A total of 56 newborns treated with hypothermia were monitored using video electroencephalography through cooling and rewarming, and then imaged at a median of 5 days. The electroencephalograms were reviewed for indications of seizure and status epilepticus. Moderate-severe injury detected on magnetic resonance imaging was measured using a classification scheme similar to one predicting abnormal outcome in an analogous population. RESULTS: Seizures were recorded in 17 newborns (30%), 5 with status epilepticus. Moderate-severe injury was more common in newborns with seizures (relative risk, 2.9; 95% CI, 1.2-4.5; P=.02), and was present in all 5 newborns with status epilepticus. Newborns with moderate-severe injury had seizures that were multifocal and of later onset, and they were more likely to experience recurrent seizures after treatment with 20 mg/kg phenobarbital. Newborns with only subclinical seizures were as likely to have injury as those with seizures with a clinical correlate (57% vs 60%). CONCLUSION: Seizures represent a risk factor for brain injury in the setting of therapeutic hypothermia, especially in neonates with status epilepticus, multifocal-onset seizures, and a need for multiple medications. However, 40% of our neonates were spared from brain injury, suggesting that the outcome after seizures is not uniformly poor in children treated with therapeutic hypothermia. |
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Authors:
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Hannah C Glass; Kendall B Nash; Sonia L Bonifacio; A James Barkovich; Donna M Ferriero; Joseph E Sullivan; Maria Roberta Cilio |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2011-08-11 |
Journal Detail:
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Title: The Journal of pediatrics Volume: 159 ISSN: 1097-6833 ISO Abbreviation: J. Pediatr. Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-10-14 Completed Date: 2011-12-29 Revised Date: 2012-05-07 |
Medline Journal Info:
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Nlm Unique ID: 0375410 Medline TA: J Pediatr Country: United States |
Other Details:
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Languages: eng Pagination: 731-735.e1 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2011 Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Neurology, University of California San Francisco, San Francisco, CA, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anticonvulsants
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therapeutic use Brain / pathology Brain Injuries / diagnosis*, etiology Cohort Studies Drug Resistance Electroencephalography Female Humans Hypothermia, Induced* Hypoxia-Ischemia, Brain / complications, pathology, therapy* Infant, Newborn Magnetic Resonance Imaging* Male Rewarming Seizures / diagnosis*, drug therapy, etiology Severity of Illness Index Status Epilepticus / diagnosis, epidemiology Video Recording |
| Grant Support | |
ID/Acronym/Agency:
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5P50NS035902/NS/NINDS NIH HHS; K23 NS066137/NS/NINDS NIH HHS; K23 NS066137-01A1/NS/NINDS NIH HHS; K23NS066137/NS/NINDS NIH HHS; NS40117/NS/NINDS NIH HHS; P50 NS035902-03/NS/NINDS NIH HHS; UL1 RR024131/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Anticonvulsants |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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