Perinatality and Epilepsy.
Abstract number :
1.185
Submission category :
Year :
2001
Submission ID :
2968
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
M-D. Lamblin, MD, Clinical Neurophysiology, CHRU, Lille, France; A-M. D[scquote]Allest, MD, Clamart, France
RATIONALE: Epilepsy associated with cerebral palsy and/or cognitive impairment can be the consequence of severe antenatal or perinatal brain insults in premature and in full term neonates.
METHODS: The aim of our study is to evaluate through the litterature the prevalence of this epilepsy, his association with perinatal risks and propose precise prospective studies.
RESULTS: In a prospective way, by cohort studies or by case-control studies, the main results are :
- The prevalence of epilepsy is 13,8 0/00 in one year birth cohort of 12058 infants. 29% of these cases are the consequence of prenatal or perinatal insults.(the most frequent types are infantile spasms and partial epilepsies .
- The prevalence of epilepsy is 3,9 0/00 in a one week birth national study cohort of 16163 children.The most relevant factors are early abnormalities in pregnancy as hemorrhage .
- The prevalence of epilepsy associated with cerebral palsy is 30,5% in a population of 786 children ; The most frequent association is with spastic quadriplegia.
- A case-control study has showed that perinatal hypoxic-ischemic encephalopathy was a significantly determinant factor of late epilepsy .
In a retrospective study way, some etiological factors have been pointed out in populations of epileptic chilmdren (porencephaly in the west syndrom is a major rik factor).
Selective studies in premature newborn, 33w of GA looked for specific risk factors in the neonatal period ; The incidence of epilepsy increases from 2% at 1 year to 4,8% at 8 years followup.The hemorrhagic parenchymal infarction on US was the most frequent lesion in these children.
In term neonates, the association coma-neonatal seizures, early EEG abnormalities as temporal sharp slow waves, can predict significantly later epilepsy.
CONCLUSIONS: Next prospective studies should include, at the same time precise radiological (US and RMN) and EEG descriptions ; early, repetitive and late timing in particular pathologies : any risk factor during pregnancy (more specially hemorhage),specific cerebral parenchymal lesions .