Comparison of clinical, electroentephalographic and tomographic data in children with controlled and non-controlled epilepsy

Abstract

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 1st 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