TY  - JOUR
PY  - 2019//
TI  - Pattern of brain injury predicts long-term epilepsy following neonatal encephalopathy
JO  - Journal of child neurology
A1  - Xu, Qi
A1  - Chau, Vann
A1  - Sanguansermsri, Chinnuwat
A1  - Muir, Katherine E.
A1  - Tam, Emily W. Y.
A1  - Miller, Steven P.
A1  - Wong, Darren S. T.
A1  - Chen, Hao
A1  - Wong, Peter K. H.
A1  - Zwicker, Jill G.
A1  - Poskitt, Kenneth J.
A1  - Hill, Alan
A1  - Roland, Elke H.
SP  - 883073818822361
EP  - 883073818822361
VL  - ePub
IS  - ePub
N2  - OBJECTIVE:: To determine if patterns of hypoxic-ischemic brain injury on magnetic resonance imaging (MRI) in term newborns predict subsequent childhood epilepsy. <br><br>METHODS: This retrospective cohort study includes term newborns with encephalopathy (n = 181) born between 2004-2012 and admitted to British Columbia Children's Hospital. MRI was performed between 3 and 5 days of age. The predominant patterns of hypoxic-ischemic injury were classified as Normal, Watershed, Basal Nuclei, Total, and Focal-Multifocal. Lesions in hippocampus, motor and occipital cortex were noted. <br><br>RESULTS:: Of 181 newborns, 166 (92%) survived the neonatal period, and 132 (80%) had follow-up with a median duration of 61 months (IQR: 28-95). Twenty-three children (17%) developed epilepsy. A higher proportion with Watershed, Basal Nuclei, or Total patterns developed epilepsy ( P <.001). Injury to motor cortex, hippocampus, and occipital lobe ( P <.01) were independent risk factors for epilepsy. In the adjusting logistic model, Watershed (odds ratio = 16.0, 95% CI [1.3, 197.2], P =.03) and Basal Nuclei injury (odds ratio = 19.4, 95% CI [1.9, 196.3], P =.01) remained independent risk factors. Therapeutic hypothermia did not alter these associations. Severity of brain injury and recurrent neonatal seizures are other clinical risk factors. Significance: In term newborns with hypoxic-ischemic encephalopathy, the predominant pattern of Watershed and Basal Nuclei injury are valuable predictors for development of epilepsy in later childhood.<p />  <p>Language: en</p>
LA  - en
SN  - 0883-0738
UR  - http://dx.doi.org/10.1177/0883073818822361
ID  - ref1
ER  -