Seizure burden and neurodevelopmental outcome in neonates with hypoxic-ischemic encephalopathy.

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dc.contributor.author Kharoshankaya, Liudmila
dc.contributor.author Stevenson, Nathan J.
dc.contributor.author Livingstone, Vicki
dc.contributor.author Murray, Deirdre M.
dc.contributor.author Murphy, Brendan P.
dc.contributor.author Ahearne, Caroline E.
dc.contributor.author Boylan, Geraldine B.
dc.date.accessioned 2016-09-27T09:21:18Z
dc.date.available 2016-09-27T09:21:18Z
dc.date.issued 2016-09
dc.identifier.citation KHAROSHANKAYA, L., STEVENSON, N. J., LIVINGSTONE, V., MURRAY, D. M., MURPHY, B. P., AHEARNE, C. E. & BOYLAN, G. B. 2016. Seizure burden and neurodevelopmental outcome in neonates with hypoxic–ischemic encephalopathy. Developmental Medicine & Child Neurology, [In Press] doi: 10.1111/dmcn.13215 en
dc.identifier.issn 1469-8749
dc.identifier.uri http://hdl.handle.net/10468/3118
dc.identifier.doi 10.1111/dmcn.13215
dc.description.abstract Aim: To examine the relationship between electrographic seizures and long-term outcome in neonates with hypoxic-ischemic encephalopathy (HIE). Method: Full-term neonates with HIE born in Cork University Maternity Hospital from 2003 to 2006 (pre-hypothermia era) and 2009 to 2012 (hypothermia era) were included in this observational study. All had early continuous electroencephalography monitoring. All electrographic seizures were annotated. The total seizure burden and hourly seizure burden were calculated. Outcome (normal/abnormal) was assessed at 24 to 48 months in surviving neonates using either the Bayley Scales of Infant and Toddler Development, Third Edition or the Griffiths Mental Development Scales; a diagnosis of cerebral palsy or epilepsy was also considered an abnormal outcome. Results: Continuous electroencephalography was recorded for a median of 57.1 hours (interquartile range 33.5-80.5h) in 47 neonates (31 males, 16 females); 29 out of 47 (62%) had electrographic seizures and 25 out of 47 (53%) had an abnormal outcome. The presence of seizures per se was not associated with abnormal outcome (p=0.126); however, the odds of an abnormal outcome increased over ninefold (odds ratio [OR] 9.56; 95% confidence interval [95% CI] 2.43-37.67) if a neonate had a total seizure burden of more than 40 minutes (p=0.001), and eightfold (OR: 8.00; 95% CI: 2.06-31.07) if a neonate had a maximum hourly seizure burden of more than 13 minutes per hour (p=0.003). Controlling for electrographic HIE grade or treatment with hypothermia did not change the direction of the relationship between seizure burden and outcome. Interpretation: In HIE, a high electrographic seizure burden is significantly associated with abnormal outcome, independent of HIE severity or treatment with hypothermia. en
dc.description.sponsorship Science Foundation Ireland (Principal Investigator Award (SFI 10/IN.1/B3036) Science Foundation Ireland Centres Programme (12/RC/2272)); Wellcome Trust (Strategic Translational Award 098983) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher John Wiley & Sons Ltd on behalf of Mac Keith Press en
dc.rights ©2016 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press. DOI: 10.1111/dmcn.13215 This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/ en
dc.subject Hypoxic–ischemic encephalopathy en
dc.subject Electroencephalography en
dc.subject Child neurology en
dc.subject Seizures en
dc.title Seizure burden and neurodevelopmental outcome in neonates with hypoxic-ischemic encephalopathy. en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Geraldine Boylan, Medicine , University College Cork, Cork, Ireland. +353-21-490-3000 Email: g.boylan@ucc.ie en
dc.internal.availability Full text available en
dc.date.updated 2016-09-27T09:14:12Z
dc.description.version Published Version en
dc.internal.rssid 365718277
dc.internal.pmid 27595841
dc.contributor.funder Science Foundation Ireland en
dc.contributor.funder Wellcome Trust, United Kingdom
dc.description.status Peer reviewed en
dc.identifier.journaltitle Developmental Medicine and Child Neurology en
dc.internal.copyrightchecked Yes en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress g.boylan@ucc.ie en
dc.internal.bibliocheck Check volumne, issue, pagination, citation.


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©2016 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press. DOI: 10.1111/dmcn.13215 This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Except where otherwise noted, this item's license is described as ©2016 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press. DOI: 10.1111/dmcn.13215 This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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