Prediction of Future Epilepsy in Neonates with Hypoxic-Ischemic Encephalopathy Who Received Selective Head Cooling

Tiffani L. McDonough, Juliann M. Paolicchi, Linda A. Heier, Nikkan Das, Murray Engel, Jeffrey M. Perlman, Zachary M. Grinspan*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Epilepsy outcomes after therapeutic hypothermia for neonates with hypoxic-ischemic encephalopathy are understudied. The authors used multivariable logistic regression to predict epilepsy in neonates after selective head cooling. Sensitivity analyses used magnetic resonance imaging (MRI) and electroencephalogram (EEG) interpretations by different clinicians. Fifty neonates had 2-year follow-up. Nine developed epilepsy. Predictors included pH ≤6.8 on day of birth (adjusted odds ratio [OR] 19 [95% confidence interval (CI) 1-371]), burst suppression on EEG on day 4 (8.2 [1.3-59]), and MRI deep gray matter injury (OR 33 [2.4-460]). These factors stratify neonates into low (0-1 factors; 3% [0%-14%] risk), medium (2 factors; 56% [21%-86%] risk), and high-risk groups (3 factors; 100% [29%-100%] risk) for epilepsy. The stratification was robust to varying clinical interpretations of the MRI and EEG. Neonates with hypoxic-ischemic encephalopathy who undergo selective head cooling appear at risk of epilepsy if they have 2 to 3 identified factors. If validated, this rule may help counsel families and identify children for close clinical follow-up.

Original languageEnglish (US)
Pages (from-to)630-637
Number of pages8
JournalJournal of child neurology
Volume32
Issue number7
DOIs
StatePublished - Jun 1 2017

Keywords

  • all epilepsy / seizures
  • childhood stroke
  • cohort studies
  • cohort studies
  • epilepsy
  • risk factors in epidemiology

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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