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Neonatal encephalopathy

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https://www.readbyqxmd.com/read/28428183/risk-and-burden-of-adverse-intrapartum-related-outcomes-associated-with-non-cephalic-and-multiple-birth-in-rural-nepal-a-prospective-cohort-study
#1
Naoko Kozuki, Joanne Katz, Subarna K Khatry, James M Tielsch, Steven C LeClerq, Luke C Mullany
OBJECTIVES: Intrapartum-related complications are the second leading cause of neonatal death worldwide. We estimate the community-level risk and burden of intrapartum-related fetal/neonatal mortality and morbidity associated with non-cephalic and multiple birth in rural Sarlahi District, Nepal. DESIGN: Community-based prospective cohort study. SETTING: Rural Sarlahi District, Nepal. PARTICIPANTS: Pregnant women residing in the study area...
April 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28420012/vitamin-b6-responsive-epilepsy-due-to-a-novel-kcnq2-mutation
#2
Kerstin Alexandra Klotz, Johannes R Lemke, Rudolf Korinthenberg, Julia Jacobs
Mutations in KCNQ2, encoding for subunits of potassium channels, are known to cause neonatal epileptic encephalopathy (NEE). Therapeutic options for these children are often limited. Recently, there are indications that some patients with KCNQ2 NEE show seizure response to vitamin B6 (VB6) therapy. We present a young infant with severe KCNQ2 encephalopathy resulting from a novel de novo mutation (c.1023G>C; p.(Gln341His)). In our patient, VB6 responsiveness could be demonstrated clearly by remarkable seizure-response to VB6 therapy and seizure exacerbation to discontinuation of VB6 therapy...
April 18, 2017: Neuropediatrics
https://www.readbyqxmd.com/read/28418828/a-comparison-of-blood-and-cerebrospinal-fluid-cytokines-il-1%C3%AE-il-6-il-18-tnf-%C3%AE-in-neonates-with-perinatal-hypoxia
#3
Darinka Šumanović-Glamuzina, Filip Čulo, Melanie Ivana Čulo, Paško Konjevoda, Marjana Jerković-Raguž
Perinatal hypoxia-ischemia is a specific and important pathological event in neonatal care practice. The data on relationship between the concentrations of cytokines in blood and cerebrospinal fluid (CSF) and perinatal brain injury are scarce. The aim of this study is to evaluate changes in interleukin (IL-1β, IL-6, and IL-18) and tumor necrosis factor alpha (TNF-α) levels in newborns with perinatal hypoxia (PNH). CSF and serum samples of 35 term and near-term (35-40 weeks) newborns with PNH, at the age of 3-96 hours, were analyzed using enzyme-linked immunosorbent assay...
April 18, 2017: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/28416250/therapeutic-hypothermia-for-neonates-with-hypoxic-ischemic-encephalopathy
#4
REVIEW
Ming-Chou Chiang, Yuh-Jyh Jong, Chyi-Her Lin
Therapeutic hypothermia (TH) is a recommended regimen for newborn infants who are at or near term with evolving moderate-to-severe hypoxic ischemic encephalopathy (HIE). The Task Force of the Taiwan Child Neurology Society and the Taiwan Society of Neonatology held a joint meeting in 2015 to establish recommendations for using TH on newborn patients with HIE. Based on current evidence and experts' experiences, this review article summarizes the key points and recommendations regarding TH for newborns with HIE, including: (1) selection criteria for TH; (2) choices of method and equipment for TH; (3) TH prior to and during transport; (4) methods for temperature maintenance, monitoring, and rewarming; (5) systemic care of patients during TH, including the care of respiratory and cardiovascular systems, management of fluids, electrolytes, and nutrition, as well as sedation and drug metabolism; (6) monitoring and management of seizures; (7) neuroimaging, prognostic factors, and outcomes; and (8) adjuvant therapy for TH...
March 27, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28411234/phenotype-of-gaba-transaminase-deficiency
#5
Mary Kay Koenig, Ryan Hodgeman, James J Riviello, Wendy Chung, Jennifer Bain, Claudia A Chiriboga, Kazushi Ichikawa, Hitoshi Osaka, Megumi Tsuji, K Michael Gibson, Penelope E Bonnen, Phillip L Pearl
OBJECTIVE: We report a case series of 10 patients with γ-aminobutyric acid (GABA)-transaminase deficiency including a novel therapeutic trial and an expanded phenotype. METHODS: Case ascertainment, literature review, comprehensive evaluations, and long-term treatment with flumazenil. RESULTS: All patients presented with neonatal or early infantile-onset encephalopathy; other features were hypotonia, hypersomnolence, epilepsy, choreoathetosis, and accelerated linear growth...
April 14, 2017: Neurology
https://www.readbyqxmd.com/read/28411097/-acute-liver-failure-related-to-inherited-metabolic-diseases-in-young-children
#6
Filipa Dias Costa, Rita Moinho, Sandra Ferreira, Paula Garcia, Luísa Diogo, Isabel Gonçalves, Carla Pinto
INTRODUCTION: Pediatric acute liver failure (ALF) due to inherited metabolic diseases (IMD) is a rare life-threatening condition with a poor prognosis. Early intervention may be lifesaving. OBJECTIVE: To describe clinical presentation, investigation and outcomes of ALF related to IMD in young children. MATERIAL AND METHODS: Retrospective review of the medical records of children aged up to 24 months, admitted to a tertiary pediatric and neonatal Intensive Care Unit during a 27-year period, fulfilling the ALF criteria, with documented metabolic etiology...
April 11, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28409761/the-question-of-whether-or-not-to-perform-therapeutic-hypothermia-a-case-of-neonatal-spinal-cord-injury
#7
K Yokoi, S Kobayashi, K Muramatsu, S Suzuki, H Gotou
Neonatal spinal cord injury is an extremely rare perinatal complication that often occurs concurrently with hypoxic ischemic encephalopathy (HIE), further complicating diagnosis of spinal cord injury. Although therapeutic hypothermia for moderate to severe HIE is widely recommended in Japan, it is difficult to determine whether it satisfies the neurological findings-related entry criteria in some patients.We describe a female infant with neonatal spinal cord injury after forceps delivery, who underwent therapeutic hypothermia upon diagnosis of HIE...
April 8, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28409211/risks-of-asphyxia-related-neonatal-complications-in-offspring-of-mothers-with-type-1-or-type-2-diabetes-the-impact-of-maternal-overweight-and-obesity
#8
Sven Cnattingius, Anna Lindam, Martina Persson
AIMS/HYPOTHESIS: We aimed to compare the risks of severe asphyxia-related neonatal complications in the offspring of mothers with type 1 or type 2 diabetes, and to assess the impact of maternal overweight/obesity on these risks. METHODS: This was a population-based study of 1,343,751 live-born singleton infants in Sweden between 1997 and 2011, including 5941 and 711 infants of mothers with type 1 and type 2 diabetes, respectively. ORs with 95% CIs were calculated for low Apgar score (0-6) at 5 min after birth, hypoxic ischaemic encephalopathy and neonatal seizures...
April 13, 2017: Diabetologia
https://www.readbyqxmd.com/read/28403205/spontaneous-diseases-in-captive-ratites-struthioniformes-in-northwestern-germany-a-retrospective-study
#9
Aimara Bello, Samuel Frei, Martin Peters, Anne Balkema-Buschmann, Wolfgang Baumgärtner, Peter Wohlsein
A retrospective study was carried out to define the spectrum of spontaneous diseases in ostriches and few other captive ratites, order Struthioniformes, in northwestern Germany. The investigation included 71 ratites necropsied between 1968 and 2014. They consisted of 54 ostriches, 5 emus, and 12 rheas with 37 adults, 23 juveniles and 11 neonates and embryonated eggs. Necropsy reports were reviewed, histologic preparations were re-examined and additional histochemical and immunohistochemical stains were carried out in selected cases...
2017: PloS One
https://www.readbyqxmd.com/read/28401998/early-discontinuation-of-antiseizure-medications-in-neonates-with-hypoxic-ischemic-encephalopathy
#10
Mark P Fitzgerald, Sudha Kilaru Kessler, Nicholas S Abend
OBJECTIVE: Neonates with hypoxic-ischemic encephalopathy (HIE) managed with therapeutic hypothermia (TH) often experience acute symptomatic seizures, prompting treatment with antiseizure medications (ASMs). Because the risk of seizure occurrence after hospital discharge is unknown, the optimal ASM treatment duration is unclear. We aimed to determine the risk of seizure occurrence after hospital discharge and the impact of ASM treatment duration on this outcome. METHODS: We performed a single-center, retrospective study of consecutive neonates with HIE managed with TH who received ASMs for acute symptomatic seizures from June 2010 through December 2014...
April 12, 2017: Epilepsia
https://www.readbyqxmd.com/read/28395175/oxygen-and-oxidative-stress-in-the-perinatal-period
#11
REVIEW
Isabel Torres-Cuevas, Anna Parra-Llorca, Angel Sánchez-Illana, Antonio Nuñez-Ramiro, Julia Kuligowski, Consuelo Cháfer-Pericás, María Cernada, Justo Escobar, Máximo Vento
Fetal life evolves in a hypoxic environment. Changes in the oxygen content in utero caused by conditions such as pre-eclampsia or type I diabetes or by oxygen supplementation to the mother lead to increased free radical production and correlate with perinatal outcomes. In the fetal-to-neonatal transition asphyxia is characterized by intermittent periods of hypoxia ischemia that may evolve to hypoxic ischemic encephalopathy associated with neurocognitive, motor, and neurosensorial impairment. Free radicals generated upon reoxygenation may notably increase brain damage...
March 12, 2017: Redox Biology
https://www.readbyqxmd.com/read/28393884/novel-wavelet-real-time-analysis-of-neurovascular-coupling-in-neonatal-encephalopathy
#12
Lina F Chalak, Fenghua Tian, Beverley Adams-Huet, Diana Vasil, Abbot Laptook, Takashi Tarumi, Rong Zhang
Birth asphyxia constitutes a major global public health burden for millions of infants, despite hypothermia therapy. There is a critical need for real time surrogate markers of therapeutic success, to aid in patient selection and/or modification of interventions in neonatal encephalopathy (NE). This is a proof of concept study aiming to quantify neurovascular coupling (NVC) using wavelet analysis of the dynamic coherence between amplitude-integrated electroencephalography (aEEG) and near-infrared spectroscopy in NE...
April 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28391772/intrapartum-fever-and-the-risk-for-perinatal-complications-the-effect-of-fever-duration-and-positive-cultures
#13
Eran Ashwal, Lina Salman, Yossi Tzur, Amir Aviram, Tali Ben-Mayor Bashi, Yariv Yogev, Liran Hiserch
OBJECTIVE: To estimate the association between intrapartum fever and adverse perinatal outcome. METHODS: A retrospective cohort study of women attempting vaginal delivery at term in a tertiary hospital (2012-2015). Perinatal outcome of deliveries complicated by intrapartum fever (≥38.0 °C) were compared to women with no intrapartum fever matched by parity and gestational age at delivery in a 1:2 ratio. Maternal outcome included cesarean section (CS), operative vaginal delivery (OVD), retained placenta or post-partum hemorrhage...
April 10, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28391258/dexmedetomidine-combined-with-therapeutic-hypothermia-is-associated-with-cardiovascular-instability-and-neurotoxicity-in-a-piglet-model-of-perinatal-asphyxia
#14
Mojgan Ezzati, Go Kawano, Eridan Rocha-Ferreira, Daniel Alonso-Alconada, Jane K Hassell, Kevin D Broad, Igor Fierens, Bobbi Fleiss, Alan Bainbridge, David L Price, Pardis Kaynezhad, Brian Anderson, Mariya Hristova, Ilias Tachtsidis, Xavier Golay, Pierre Gressens, Robert D Sanders, Nicola J Robertson
The selective α2-adrenoreceptor agonist dexmedetomidine has shown neuroprotective, analgesic, anti-inflammatory, and sympatholytic properties that may be beneficial in neonatal encephalopathy (NE). As therapeutic hypothermia is only partially effective, adjunct therapies are needed to optimize outcomes. The aim was to assess whether hypothermia + dexmedetomidine treatment augments neuroprotection compared to routine treatment (hypothermia + fentanyl sedation) in a piglet model of NE using magnetic resonance spectroscopy (MRS) biomarkers, which predict outcomes in babies with NE, and immunohistochemistry...
April 8, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28391250/confirmation-of-mutations-in-prosc-as-a-novel-cause-of-vitamin-b6-dependent-epilepsy
#15
Barbara Plecko, Markus Zweier, Anaïs Begemann, Deborah Mathis, Bernhard Schmitt, Pasquale Striano, Martina Baethmann, Stella Maria Vari, Francesca Beccaria, Federico Zara, Lisa M Crowther, Pascal Joset, Heinrich Sticht, Sorina Mihaela Papuc, Anita Rauch
Vitamin-B6-dependent epilepsies are a heterogenous group of treatable disorders due to mutations in several genes (ALDH7A1, PNPO, ALPL or ALDH4A1). In neonatal seizures, defects in ALDH7A1 and PNPO explain a major fraction of cases. Very recently biallelic mutations in PROSC were shown to be a novel cause in five families. We identified four further unrelated patients harbouring a total of six different mutations, including four novel disease mutations. Vitamin B6 plasma profiles on pyridoxine did not enable the differentiation of patients with PROSC mutations...
April 8, 2017: Journal of Medical Genetics
https://www.readbyqxmd.com/read/28389438/management-and-investigation-of-neonatal-encephalopathy-2017-update
#16
Kathryn Martinello, Anthony R Hart, Sufin Yap, Subhabrata Mitra, Nicola J Robertson
This review discusses an approach to determining the cause of neonatal encephalopathy, as well as current evidence on resuscitation and subsequent management of hypoxic-ischaemic encephalopathy (HIE). Encephalopathy in neonates can be due to varied aetiologies in addition to hypoxic-ischaemia. A combination of careful history, examination and the judicious use of investigations can help determine the cause. Over the last 7 years, infants with moderate to severe HIE have benefited from the introduction of routine therapeutic hypothermia; the number needed to treat for an additional beneficial outcome is 7 (95% CI 5 to 10)...
April 6, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28384785/maternal-body-mass-index-in-early-pregnancy-and-risk-of-epilepsy-in-offspring
#17
Neda Razaz, Kristina Tedroff, Eduardo Villamor, Sven Cnattingius
Importance: There is growing concern about the long-term neurologic effects of prenatal exposure to maternal overweight and obesity. The causes of epilepsy are poorly understood and, in more than 60% of the patients, no definitive cause can be determined. Objectives: To investigate the association between early pregnancy body mass index (BMI) and the risk of childhood epilepsy and examine associations between obesity-related pregnancy and neonatal complications and risks of childhood epilepsy...
April 3, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28374415/biventricular-function-on-early-echocardiograms-in-neonatal-hypoxic-ischemic-encephalopathy
#18
Sanjeev Aggarwal, Girija Natarajan
AIM: To compare early (<24 hours) echocardiograms (ECHOs) in infants with perinatal hypoxic-ischemic encephalopathy (HIE) undergoing a)therapeutic hypothermia (TH) b) normothermia and c) normal controls. METHODS: This was a single center retrospective review of clinical early ECHOs of term infants with moderate or severe HIE and controls (with a normal ECHO <72 hours of age). Right (RVO) and left ventricular output (LVO), RV and LV myocardial performance index (MPI), systolic to diastolic duration ratio (S/D) and eccentricity indices (EI) in systole and diastole were compared using ANOVA...
April 4, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28369606/comparison-of-two-low-cost-methods-of-cooling-neonates-with-hypoxic-ischemic-encephalopathy
#19
Machilakath Panangandi Shabeer, Thangaraj Abiramalatha, Abhilasha Smith, Pradita Shrestha, Grace Rebekah, Arulmoorthy Meghala, Niranjan Thomas
Background: Several low-cost methods are used in resource-limited settings to provide therapeutic hypothermia in asphyxiated neonates. There is inadequate data about their efficacy and safety. This is a retrospective study comparing two low-cost cooling methods-frozen gel packs (FGP) and phase changing material (PCM). Results: There were 23 babies in FGP and 45 babies in the PCM group. Induction time was significantly shorter with FGP than PCM (45 vs. 90 minutes; p -value < 0...
October 5, 2016: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28359187/prediction-of-future-epilepsy-in-neonates-with-hypoxic-ischemic-encephalopathy-who-received-selective-head-cooling
#20
Tiffani L McDonough, Juliann M Paolicchi, Linda A Heier, Nikkan Das, Murray Engel, Jeffrey M Perlman, Zachary M Grinspan
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...
January 1, 2017: Journal of Child Neurology
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