| Title: |
Postneonatal epilepsy after acute provoked neonatal seizures: Incidence, predictors, and clinical burden in a multicenter cohort followed through early childhood |
| Authors: |
Numis, Adam L.; Glass, Hannah C.; Soul, Janet S.; Wusthoff, Courtney J.; Massey, Shavonne L.; Benedetti, Giulia M.; Chu, Catherine J.; Thomas, Cameron; Anwar, Tayyba; Lemmon, Monica E.; Franck, Linda S.; Berl, Madison M.; Pilon, Betsy; Rau, Stephanie M. D.; Li, Yi; Sturza, Julie; McCulloch, Charles E.; Shellhaas, Renée A. |
| Contributors: |
National Institutes of Health; Patient-Centered Outcomes Research Institute |
| Source: |
Epilepsia ; ISSN 0013-9580 1528-1167 |
| Publisher Information: |
Wiley |
| Publication Year: |
2025 |
| Collection: |
Wiley Online Library (Open Access Articles via Crossref) |
| Description: |
Objective Epilepsy is a known potential outcome following acute provoked neonatal seizures, but its onset, treatment patterns, and health care utilization through childhood remain poorly characterized. This study aimed to define the incidence and timing of postneonatal epilepsy, identify perinatal predictors, and describe the clinical burden of epilepsy among survivors of acute provoked neonatal seizures through early childhood. Methods This prospective, multicenter cohort study followed neonates with acute provoked seizures from the Neonatal Seizure Registry (NSR‐II) in an extended follow‐up through early childhood (Developmental Functional Evaluation). Neonatal clinical and neuroimaging data were collected, and epilepsy outcomes (including semiology, treatments, and health care use) were assessed annually through at least 5 years via structured interviews and medical record review. Kaplan–Meier and Cox proportional hazards models evaluated epilepsy risk, with data censored at loss to follow‐up. Results Among 282 neonates evaluated for epilepsy in NSR‐II, 183 (65%) continued into the extended follow‐up study. Across the entire follow‐up period through early childhood, 50 (18%) developed epilepsy, with a cumulative incidence of 21.6% (95% confidence interval [CI] = 16.7%–27.7%). Earlier epilepsy onset was associated with ≥3 days of neonatal seizures (hazard ratio [HR] = 2.8, 95% CI = 1.5–5.2), abnormal discharge neurological exam (HR = 2.4, 95% CI = 1.3–4.4), and deep gray/brainstem injury (HR = 2.4, 95% CI = 1.2–4.7). Prematurity ( |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1111/epi.18590 |
| Availability: |
https://doi.org/10.1111/epi.18590; https://onlinelibrary.wiley.com/doi/pdf/10.1111/epi.18590 |
| Rights: |
http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| Accession Number: |
edsbas.8699BD70 |
| Database: |
BASE |