THE IMPORTANCE OF THE ETIOLOGIC FACTORS OF NEONATAL SEIZURES IN THE FORMATION AND THE CURRENT OF EPILEPSY

Sukhonosova O. Yu.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The prognosis and long-term consequences of neonatal seizures are determined by their etiological factors. Purpose: to analyze importance of etiology of neonatal seizures in formation of epilepsy in children of early age. Method.There were 236 children at the age of 3 who suffered neonatal seizures under supervision. All patients underwent somatic and neurological examination, EEG, EEG video monitoring, MRI of the brain, laboratory methods with metabolic control, genetic testing and virological examination in the neonatal period and later. Results.During the survey etiological factors of neonatal seizures were determined: hypoxic-ischemic encephalopathy (47%), intracranial hemorrhage and vascular diseases (11%), prenatal infections (7%), postnatal neuroinfections (3%), metabolic electrolyte disorders (4%), developmental disorders (dysgenesis) (8%), facomatosis (2%), withdrawal syndrome (1%), congenital metabolic desorders (2%), chromosomal syndromes (1%), congenital tumors (1%), benign neonatal seizures (3%), somatic diseases (1%), postnatal trauma (1% ), not specified (8%). According to the classification of etiology of epilepsy (32nd International Congress on Epilepsy, 2017) all patients were distributed as follows: structural – 67%, genetic –4%, infectious –10%, metabolic –4%, immunological –1%, not specified –8%, mixed –6%. According to outcomes regarding the formation of epilepsy and neurological deficiency all children at the age of 3 were divided into 3 groups: (1) without seizures up to 3 years of age and without formation of a neurological deficiency (61%); (2) with formation of epilepsy, in which medication remission was achieved, and moderate neurological deficiency (16%); (3) with formation of drug-resistant epilepsy and severe neurological deficiency (23%). Conclusion. Patients in the 1 st group had neonatal seizures due to light hypoxic-ischemic encephalopathy, somatic diseases and transient metabolic disorders. In the 2nd group causes of neonatal seizures and further epilepsy were moderate hypoxic-ischemic encephalopathy, postnatal neuroinfections and postnatal trauma. Patients with formation of drug-resistant epilepsy more often had severe hypoxic-ischemic encephalopathy, intracranial hemorrhage, congenital malformations, prenatal infections, congenital metabolic disorders, developmental disorders. The main role in the prognosis of neonatal seizures is played not so much by the fact of their presence, as by the factors that cause them. The transformation of neonatal seizures into epileptic seizures depends on the etiology of brain damage in children. With a combination of several etiological factors (two or more), the prognosis for the formation of a neurological deficit and the formation of epilepsy worsens. During the study, it was found that with a combination of 2 or more etiological factors, the incidence of epilepsy is 86.4-100%. For the unfavourable course of neonatal seizures, the etiology consists of pronounced intrauterine disorders, prematurity, severe labor and violations of postnatal development.

children, neonatal seizures, epilepsy

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«Bulletin of problems biology and medicine» Issue 1 Part 1 (142), 2018 year, 189-193 pages, index UDK 616.853-063.32:616-009.6-08

10.29254/2077-4214-2018-1-1-142-189-193