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Neonatal Seizures

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https://www.readbyqxmd.com/read/29036732/predictors-of-poor-outcome-in-neonates-with-pyogenic-meningitis-in-a-level-three-neonatal-intensive-care-unit-of-developing-country
#1
Mala Kumar, Shalini Tripathi, Himanshu Kumar, S N Singh
Background: The mortality of neonatal pyogenic meningitis is reduced to 10-15%, but morbidity is unchanged. Methods: Primary objective is to determine the outcome, i.e. death or abnormal neurological examination (NE) at discharge and abnormal developmental quotient (DQ) at 3 months. Secondary objective is to find predictors of poor outcome. Results: In all, 89 neonates enrolled, 10 expired and 24 neonates had abnormal NE at discharge. A total of 59 neonates came for follow up, 13 had DQ < 70...
September 26, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/29031613/pathogenic-mutations-of-the-human-mitochondrial-citrate-carrier-slc25a1-lead-to-impaired-citrate-export-required-for-lipid-dolichol-ubiquinone-and-sterol-synthesis
#2
Homa Majd, Martin S King, Anthony C Smith, Edmund R S Kunji
Missense mutations of the human mitochondrial citrate carrier, encoded by the SLC25A1 gene, lead to an autosomal recessive neurometabolic disorder characterised by neonatal-onset encephalopathy with severe muscular weakness, intractable seizures, respiratory distress, and lack of psychomotor development, often resulting in early death. Here, we have measured the effect of all twelve known pathogenic mutations on the transport activity. The results show that nine mutations abolish transport of citrate completely, whereas the other three reduce the transport rate by more than 70%, indicating that impaired citrate transport is the most likely primary cause of the disease...
October 11, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/29022989/prophylactic-intravenous-calcium-therapy-for-exchange-blood-transfusion-in-the-newborn
#3
REVIEW
Tinuade A Ogunlesi, Foluso Ea Lesi, Olabisi Oduwole
BACKGROUND: Exchange blood transfusion (EBT) is a form of whole blood transfusion in which the total blood volume is replaced within a few hours. In perinatal and neonatal medicine, EBT is most often used in the management of severe anaemia or severe hyperbilirubinaemia in the first week of life. Hypocalcaemia, one of the common morbidities associated with EBT, is thought to arise from the chelating effects of the citrate commonly used as an anticoagulant in the donor's blood. This disorder manifests with muscular and nervous irritability and cardiac arrhythmias...
October 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29021923/toward-a-personalized-real-time-diagnosis-in-neonatal-seizure-detection
#4
Andriy Temko, Achintya Kr Sarkar, Geraldine B Boylan, Sean Mathieson, William P Marnane, Gordon Lightbody
The problem of creating a personalized seizure detection algorithm for newborns is tackled in this paper. A probabilistic framework for semi-supervised adaptation of a generic patient-independent neonatal seizure detector is proposed. A system that is based on a combination of patient-adaptive (generative) and patient-independent (discriminative) classifiers is designed and evaluated on a large database of unedited continuous multichannel neonatal EEG recordings of over 800 h in duration. It is shown that an improvement in the detection of neonatal seizures over the course of long EEG recordings is achievable with on-the-fly incorporation of patient-specific EEG characteristics...
2017: IEEE Journal of Translational Engineering in Health and Medicine
https://www.readbyqxmd.com/read/29021168/functional-ultrasound-imaging-of-brain-activity-in-human-newborns
#5
Charlie Demene, Jérome Baranger, Miguel Bernal, Catherine Delanoe, Stéphane Auvin, Valérie Biran, Marianne Alison, Jérome Mairesse, Elisabeth Harribaud, Mathieu Pernot, Mickael Tanter, Olivier Baud
Functional neuroimaging modalities are crucial for understanding brain function, but their clinical use is challenging. Recently, the use of ultrasonic plane waves transmitted at ultrafast frame rates was shown to allow for the spatiotemporal identification of brain activation through neurovascular coupling in rodents. Using a customized flexible and noninvasive headmount, we demonstrate in human neonates that real-time functional ultrasound imaging (fUSI) is feasible by combining simultaneous continuous video-electroencephalography (EEG) recording and ultrafast Doppler (UfD) imaging of the brain microvasculature...
October 11, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28982530/variability-in-preferred-management-of-electrographic-seizures-in-neonatal-hypoxic-ischemic-encephalopathy
#6
Melanie A McNally, Adam L Hartman
BACKGROUND: Seizures may cause added harm in neonates with hypoxic-ischemic encephalopathy (HIE). Specific recommendations about seizure treatment in this context are lacking. We sought to determine the scope of practice regarding management of non-status epilepticus electrographic-only seizures in this setting. METHODS: A case-based survey was distributed to members of the Child Neurology Society. Providers were asked about their preferred management strategy for sequential clinical scenarios...
June 15, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28980090/isolated-sulfite-oxidase-deficiency
#7
Helena Claerhout, Peter Witters, Luc Régal, Katrien Jansen, Marie-Rose Van Hoestenberghe, Jeroen Breckpot, Pieter Vermeersch
Isolated sulfite oxidase deficiency (ISOD) is a life-threatening, autosomal recessive disease characterized by severe neurological impairment. As no long-term effective treatment is available, distinction from other treatable diseases, such as molybdenum cofactor deficiency (MoCD) type A, should be made. We reviewed 47 patients (45 previously reported in the literature). Cases were reviewed for consanguinity, sex, age at onset, death, clinical findings (including spasticity, seizures, psychomotor retardation, feeding difficulties, ectopia lentis, microcephaly), laboratory findings [urinary sulfite, S-sulfocysteine (in plasma and urine), plasma cystine, total homocysteine, uric acid, and oxypurines in urine] and radiological findings (including cerebral/cerebellar atrophy, cystic white matter changes, ventriculomegaly)...
October 4, 2017: Journal of Inherited Metabolic Disease
https://www.readbyqxmd.com/read/28974124/prophylactic-magnesium-sulphate-in-prevention-of-eclampsia-in-women-with-severe-preeclampsia-randomised-controlled-trial-pipes-trial
#8
Anish Keepanasseril, Dilip Kumar Maurya, K Manikandan, Yavana Suriya J, Syed Habeebullah, S Soundara Raghavan
Optimum dose, route and duration of use of prophylactic magnesium sulphate in women with severe pre-eclampsia is still controversial. We compared the efficacy and safety of 'low-dose Dhaka' regime with 'Loading dose only' regime for seizure prophylaxis in severe preeclampsia using a randomised controlled trial in 402 women. The incidence of eclampsia in the 'low-dose Dhaka' regime group was 1.49% and that in the 'Loading dose only regime' was 2.98% (p = .321). In the low-dose Dhaka regime, injection site abscess and respiratory depression occurred in one woman each...
October 3, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28963116/phelan-mcdermid-syndrome-due-to-shank3-mutation-in-an-intellectually-disabled-adult-male-successful-treatment-with-lithium
#9
Jos I M Egger, Willem M A Verhoeven, Renske Groenendijk-Reijenga, Sarina G Kant
For 30 years, Phelan and co-workers described a syndrome characterised by neonatal hypotonia, global developmental delay, strongly impaired speech, sleep disturbances and hyperreactivity to sensory stimuli. This Phelan-McDermid syndrome (PMS), also presenting with symptoms from the autism spectrum and a higher risk of developing seizure disorders, may be caused by a deletion of chromosome 22q13 or by a mutation in the SHANK3 gene. Its core psychopathological phenotype comprises symptoms from the bipolar spectrum for which generally treatment with a mood-stabilising anticonvulsant in combination with an atypical antipsychotic seems to be most effective...
September 28, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28961316/reduced-infancy-and-childhood-epilepsy-following-hypothermia-treated-neonatal-encephalopathy
#10
Xun Liu, Sally Jary, Frances Cowan, Marianne Thoresen
OBJECTIVE: To investigate what proportion of a regional cohort of cooled infants with neonatal encephalopathy develop epilepsy (determined by the International League Against Epilepsy [ILAE] definition and the number of antiepileptic drugs [AEDs]) up to 8 years of age. METHODS: From 2006-2013, 151 infants with perinatal asphyxia underwent 72 h cooling. Clinical and amplitude-integrated electroencepalography (aEEG) with single-channel EEG-verified neonatal seizures were treated with AEDs...
September 29, 2017: Epilepsia
https://www.readbyqxmd.com/read/28960717/retrospective-evaluation-of-155-adult-equids-and-21-foals-with-tetanus-in-western-northern-and-central-europe-2000-2014-part-1-description-of-history-and-clinical-evolution
#11
Gaby van Galen, Claude Saegerman, Joke Rijckaert, Helene Amory, Lara Armengou, Barbora Bezdekova, Inge Durie, Rikke Findshøj Delany, Nathalie Fouché, Laura Haley, Michael Hewetson, Rene van den Hoven, Anna Kendall, Fernando Malalana, Jessika Muller Cavalleri, Tresemiek Picavet, Katja Roscher, Denis Verwilghen, Meret Wehrli Eser, Cornélie Westermann, Tim Mair
OBJECTIVE: To describe clinical data of hospitalized adult equids and foals with tetanus. DESIGN: Multicenter retrospective study (2000-2014). SETTING: Twenty Western, Northern, and Central European university teaching hospitals and private referral centers. ANIMALS: One hundred fifty-five adult equids (>6 months) and 21 foals (<6 months) with tetanus. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Information on geographic, annual and seasonal data, demographic- and management-related data, clinical history, clinical examination and blood analysis on admission, complications, treatments, and outcomes were described and statistically compared between adults and foals...
September 28, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28958087/neonatal-sleep-wake-analyses-predict-18-month-neurodevelopmental-outcomes
#12
R A Shellhaas, J W Burns, F Hassan, M D Carlson, J D E Barks, R D Chervin
Objectives: The neurological examination of critically ill neonates is largely limited to reflexive behavior. The exam often ignores sleep-wake physiology that may reflect brain integrity and influence long-term outcomes. We assessed whether polysomnography and concurrent cerebral near-infrared spectroscopy (NIRS) might improve prediction of 18-month neurodevelopmental outcomes. Methods: Term newborns with suspected seizures underwent standardized neurologic examinations to generate Thompson scores, and had 12-hour bedside polysomnography with concurrent cerebral NIRS...
August 29, 2017: Sleep
https://www.readbyqxmd.com/read/28946157/duplex-sonographic-diagnosis-of-perinatal-hemorrhagic-stroke
#13
Karl-Heinz Deeg
Children are particularly at risk for stroke in the neonatal period. Neonatal hemorrhagic stroke is rarer than ischemic stroke. The incidence is 40.7/100 000 live births. Hemorrhagic stroke is caused by a disruption in venous drainage usually due to local thrombosis. As a result of the nonspecific clinical symptoms in this age group, diagnosis is usually made too late. The only relatively specific symptom is a cerebral seizure during the first week of life. Therefore, stroke should be ruled out by diagnostic imaging in the case of any seizure in the first days of life...
October 2017: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/28946144/cerebellar-infarction-unusual-manifestation-with-facial-palsy-focal-seizures-and-secondary-generalization
#14
Tobias Mühlbacher, Georg Bohner, Christoph Bührer, Christof Dame
BACKGROUND: Cerebellar infarction is exceedingly rare in neonates, usually occurring after traumatic birth. Lifelong sequelae can result from cerebellar damage with disorders of motor function, ataxia, and also cognitive dysfunction. OBJECTIVES/METHODS: We report the clinical presentation of a preterm triplet infant delivered by elective cesarean who showed peripheral facial palsy immediately after birth. RESULTS: Tonic seizures with high-voltage discharges over the contralateral cerebral hemisphere and secondary generalization were successfully treated with phenobarbital...
September 26, 2017: Neonatology
https://www.readbyqxmd.com/read/28942717/composite-neonatal-and-maternal-morbidities-with-small-versus-appropriate-for-gestational-age-among-uncomplicated-obese-women-undergoing-repeat-cesarean-delivery
#15
Ziad A Haidar, Oscar A Viteri, Susan Hosseini Nasab, Hind N Moussa, Baha M Sibai, Janice E Whitty
PURPOSE: Our goal was to compare composite neonatal and maternal morbidities (composite neonatal morbidity (CNM), composite maternal morbidity (CMM)) among deliveries with small for age (SGA) versus appropriate for gestational age (AGA; birthweight 10-89%) among obese versus non-obese women undergoing repeat cesarean delivery (CD). STUDY DESIGN: This is a secondary analysis of a prospective observational study. Women who had elective CD ≥37 weeks were studied...
October 10, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28940525/estimation-of-initial-phenobarbital-dosing-in-term-neonates-with-moderate-to-severe-hypoxic-ischaemic-encephalopathy-following-perinatal-asphyxia
#16
M Šíma, P Pokorná, J Hartinger, O Slanař
WHAT IS KNOWN AND OBJECTIVE: Phenobarbital is the first-line treatment of seizures in asphyxiated neonates; however, due to the high pharmacokinetic variability in this population, there is no consensus on the optimal dosage regimen. This study was conducted to identify variables that affect phenobarbital fate during routine clinical care and then to evaluate the dosage schedule that could be applied in term asphyxiated neonates with respect to achieving the target therapeutic range. METHODS: Phenobarbital pharmacokinetics was calculated based on serum concentrations measurements using one-compartmental model...
September 22, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28937832/aberrant-plasticity-in-the-hippocampus-after-neonatal-seizures
#17
Xiaoqian Zhang, Huiling Qu, Ying Wang, Shanshan Zhao, Ting Xiao, Chuansheng Zhao, Weiyu Teng
Neonatal seizures are the most frequent type of neurological disorder and those newborn babies that experience seizures carry an increased risk of epileptogenesis and other long-term morbidities. The newly generated dentate granule cells (DGCs) integrate functionally into the mature hippocampal network by continuously forming connections with their targets but this process of adult neurogenesis can be influenced by seizures. When compared to adult seizures, neonatal seizures may exert different effects on neurogenesis due to the high resistance of the newborn's neurons to cell death combined with the inherent high sensitivity to seizures in the immature brain...
September 22, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28930990/application-of-an-amplitude-integrated-eeg-monitor-cerebral-function-monitor-to-neonates
#18
Nora Bruns, Susanne Blumenthal, Irmgard Meyer, Susanne Klose-Verschuur, Ursula Felderhoff-Müser, Hanna Müller
Amplitude-integrated EEG (aEEG) is an easily accessible technique to monitor the electrocortical activity in preterm and term infants in neonatal intensive care units (NICUs). This method was first used to monitor newborns after asphyxia, providing information about future neurological outcomes. The aEEG is also helpful to select newborns who benefit from cooling. The aEEG monitoring of preterm infants is becoming more widespread, as various studies have shown that neurodevelopmental outcome is related to early aEEG tracings...
September 6, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28928561/periprocedural-management-of-vein-of-galen-aneurysmal-malformation-patients-an-11-year-experience
#19
Ajay Prasad Hrishi, Karen Ruby Lionel
CONTEXT: The vein of Galen aneurysmal malformation (VGAM) is a rare arteriovenous malformation where a dilated median prosencephalic vein provides a low-resistance conduit for intracerebral blood flow resulting in high-output cardiac failure, severe pulmonary hypertension, with or without central nervous system symptoms secondary to hydrocephalus, in the neonatal and pediatric population. AIM: This study aims to analysis of the anesthetic management of this unique subset of patients with VGAM...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28926830/a-distinctive-ictal-amplitude-integrated-electroencephalography-pattern-in-newborns-with-neonatal-epilepsy-associated-with-kcnq2-mutations
#20
Ana Vilan, José Mendes Ribeiro, Pasquale Striano, Sarah Weckhuysen, Lauren C Weeke, Eva Brilstra, Linda S de Vries, Maria Roberta Cilio
BACKGROUND: Recurrent and prolonged seizures are harmful for the developing brain, emphasizing the importance of early seizure recognition and effective therapy. Amplitude-integrated electroencephalography (aEEG) has become a valuable tool to diagnose epileptic seizures, and, in parallel, genetic etiologies are increasingly being recognized, changing the paradigm of the workup and management of neonatal seizures. OBJECTIVE: To report the ictal aEEG pattern in neonates with KCNQ2-related epilepsy...
September 20, 2017: Neonatology
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