Neonatal seizures (NS) are the most common neurological emergency in the neonatal period. The International League Against Epilepsy (ILAE) proposed a new classification of NS based on semiology and highlighted the correlation between semiology and aetiology. However, neurodevelopmental outcomes have not been comprehensively evaluated based on this new classification. To evaluate neurodevelopmental outcomes and potential risk factors for severe outcomes in NS. Patients with video electroencephalogram confirmed NS were evaluated. Seizure aetiology, cerebral magnetic resonance imaging (MRI) data, background electroencephalograms data, general movements, and neurodevelopmental outcomes were analysed. Severe outcomes were one of the following: death, cerebral palsy, Griffiths developmental quotient <70, epilepsy, deafness, or blindness. A total of 74 neonates were evaluated: 62 (83.8 %) with acute provoked NS (primarily hypoxic-ischaemic encephalopathy), and 12 (16.2 %) with neonatal-onset epilepsies (self-limited neonatal epilepsy, developmental and epileptic encephalopathy, cerebral malformations). Of these, 32 (43.2 %) had electrographic seizures, while 42 (56.7 %) had electroclinical seizures – 38 (90.5 %) were motor (42.1 % clonic) and 4 (9.5 %) were non-motor phenomena. Severe outcomes occurred in 33 of the 74 (44.6 %) participants. In multivariate analysis, neonatal-onset epilepsies (odds ratio [OR]: 1.3; 95 % confidence interval [CI]: 1.1–1.6), status epilepticus (OR: 5.4; 95 % CI: 1.5–19.9), and abnormal general movements (OR: 3.4; 95 % CI: 1.9–7.6) were associated with severe outcomes. At present, hypoxic-ischaemic encephalopathy remains the most frequent aetiology of NS. The prognosis of neonatal-onset epilepsies was worse than that of acute provoked NS, and status epilepticus was the most predictive factor for adverse outcomes.

中文翻译：

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新生儿癫痫发作的神经发育结局：一项纵向研究

介绍

新生儿癫痫发作（NS）是新生儿期最常见的神经急症。国际抗癫痫联盟（ILAE）提出了基于症状学的新的NS分类，并强调了症状学与病因学之间的相关性。然而，神经发育结果尚未根据这一新分类进行全面评估。

目标

评估 NS 的神经发育结局和严重结局的潜在危险因素。

方法

对视频脑电图证实 NS 的患者进行了评估。分析了癫痫病因、脑磁共振成像（MRI）数据、背景脑电图数据、一般运动和神经发育结果。严重后果是以下之一：死亡、脑瘫、格里菲斯发育商<70、癫痫、耳聋或失明。

结果

总共 74 名新生儿接受了评估：62 名（83.8%）患有急性诱发 NS（原发性缺氧缺血性脑病），12 名（16.2%）患有新生儿癫痫（自限性新生儿癫痫、发育性和癫痫性脑病、脑畸形） ）。其中，32 例（43.2%）有电图癫痫发作，42 例（56.7%）有电临床癫痫发作，其中 38 例（90.5%）为运动性癫痫发作（42.1%）为阵挛性癫痫发作，4 例（9.5%）为非运动性癫痫发作。74 名参与者中有 33 名（44.6%）出现了严重后果。在多变量分析中，新生儿癫痫（比值比 [OR]：1.3；95% 置信区间 [CI]：1.1–1.6）、癫痫持续状态（OR：5.4；95% CI：1.5–19.9）和异常全身运动（OR：3.4；95% CI：1.9–7.6）与严重后果相关。

结论

目前，缺氧缺血性脑病仍然是 NS 最常见的病因。新生儿癫痫的预后比急性诱发的 NS 差，癫痫持续状态是不良结局的最有预测因素。