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Epilepsy burden in NHBI (Neonatal Hypoglycemic Brain Injury)
Last modified: 2018-09-09
Abstract
- Introduction: It is well known that NHBI is common cause of epilepsy. In this study we want to study how epilepsy due to NHBI behaves. We studied about age of onset of epilepsy, first seizure type in epilepsy, types of seizures, burden of refractory epilepsy and average number of AEDs used.
- Methods: Retrospective chart review of 100 consecutive NHBI patients at outpatient clinic over 10 months study period (from July 2017 to April 2018). Infants and children with history of hypoglycaemia without evidence of hypoxic-ischemic encephalopathy during neonatal period (No specific definition of hypoglycemia was used in this study and mention of hypoglycemia in neonatal discharge summary was considered appropriate) and MRI findings of Unilateral or Bilateral Parieto-occipital gliosis with or without thalamic and other white matter changes were taken as NHBI.
- Results: Epilepsy can present at any age group from infancy to adolescents with highest numbers during infancy. Almost all seizure types present with NHBI (infantile spasms (IS), tonic seizures, clonic seizures, GTCs, Focal occipital with secondary generalized seizures). Focal seizure and IS are most common seizure types observed. Almost 60% patients had refractory epilepsy. Recurrence rate of infantile spasm after stopping steroids is around 90%.
- Conclusion: Focal seizures and IS are commonest seizure type at presentation and Infancy is commonest age group where epilepsy starts. Burden of refractory epilepsy is high amongst patients with NHBI. Recurrence after steroid withdrawal is very high in IS subgroup.
Keywords
NHBI((Neonatal Hypoglycemic Brain Injury),Infantile spasm,Refractory epilpesy
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