Abstracts

Rationale: To characterize patients that develop epilepsy after whole body hypothermia for neonatal hypoxic-ischemic encephalopathy. Methods: This is a retrospective review of 34 newborns transferred to a tertiary care NICU for therapeutic whole-body cooling using the NICHD protocol [Shankaran et al 2005]. Continuous video-EEG monitoring was performed throughout the 72hrs of cooling and rewarming. Charts were reviewed for most recent neurologic and/or neurodevelopmental follow up and neurologic impairments were extracted from the clinic notes. Neurodevelopmental outcomes were grouped into normal, mild disability (< 50% developmental delay) or severe disability (microcephaly, >50% developmental delay or completely dependent). Epilepsy is defined as unprovoked recurrent seizures beyond the neonatal period, requiring anticonvulsant therapy at the time of assessment.Results: Six (18%) had epilepsy at last follow up. Four had EEG confirmed seizures during hypothermia. Six with EEG confirmed seizures during cooling have not developed epilepsy at this time. There were 2 peaks to the age of onset of epilepsy, 0-4 months of life, and 1-4 years of life. All 3 patients with early onset epilepsy were controlled at the last follow up. All 3 patients with later-onset epilepsy have incomplete control of seizures.Conclusions: 18 % of infants with hypoxic-ischemic encephalopathy developed epilepsy. Infants with an earlier epilepsy onset appear to have a more benign epilepsy course than those with later-onset. Additional studies are needed to assess incidence and risk factors for epilepsy in this population.