Abstracts

To describe the frequency of epilepsy and its co-morbidities in an entire population of children with identified with clinical neonatal seizures and explore for early prognostic clinical markers. Ninety neonates with clinical neonatal seizures up to 44 weeks gestation were prospectively identified across the island of Newfoundland involving all obstetrical and neonatal units, from 1990-1995. This cohort represents the entire population with clinical neonatal seizures. To improve and streamline seizure recognition video assisted educational sessions of the different paroxysmal behaviors, including stimulation and restraint maneuvers, were given to all units in 1989 (J Pediatr 1999;134:71-75). In 2004/5 data from all health facilities was collected and reviewed, followed by up to date history and examination. Follow-up data was collected on 78 (73% term) out of 85 subjects who survived the neonatal period. Epilepsy developed in 32 (41%) of whom 21 were born at term (37% of all term) and 11 preterm (52% of all preterm). All 10 who died, including the 3 with infantile spasms, had additional mental retardation and CP. Of the 22 who survived, 14 (64%) still have ongoing epilepsy. Of the 7 children without any co-morbidity: 5 had recognizable benign epileptic syndromes. Most common etiologies for the epilepsy were neonatal encephalopathy = 12, CNS infections = 7, cerebral dysgenesis =5, benign familial neonatal seizures = 4. Infants and children who experienced neonatal seizures are at an increased risk to develop epilepsy. This risk is highest for premature babies. The remote symptomatic epilepsies were usually accompanied by motor and cognitive co-morbidities. Mortality was seen only among patients whose epilepsy was associated with mental retardation and CP. (Supported by The Janeway Foundation, Newfoundland.)