Abstracts

Rationale: To evaluate the incidence of epilepsy at 3 years of age in newborns presenting with a neurological issue to a tertiary neonatal intensive care unit (NICU). Methods: This is a retrospective cohort study of all newborns admitted to the NICU at Children’s National Health System between 2004 and 2011 who received inpatient neurological consultation from the Neonatal Neurocritical Care (NNCC) team. Patients were excluded if: no charts available to review, death prior to discharge, non-neurologic diagnosis, isolated peripheral nerve injury, benign familial neonatal seizures or unknown seizure etiology, age at neurologic event > 28 days of life in term infants or > 44 weeks postmenstrual age in preterm infants.  Fisher’s Exact Test was used to evaluate differences between groups for categorical variables. Results: The NNCC service received 982 consults in the study period, of which 658 met criteria. 156 patients were lost to follow-up, leaving 502 patients in the final analysis. The incidence of epilepsy in this cohort was 22%. Factors associated with the development of epilepsy by 3 years of age included the presence of seizures in the neonatal period (RR, 1.79 [95% CI 1.43-2.24]), lower socioeconomic status (table1), and underlying diagnosis of cortical dysplasia or hydrocephalus (table 2). Having an initial abnormal EEG and MRI was also associated with an increased risk. Conclusions: This is one of the largest cohort studies looking at the overall incidence and risk factors in the newborn period associated with the development of epilepsy by 3 years of age. Funding: None