Epileptic Seizures in Neonates Treated with Hypothermia for Hypoxo-Ischemic Encephalopathy in Brazzaville, Congo: Types and Evolution  

作　　者：Josué Euberma Diatewa Dinah Happhia Boubayi Motoula-Latou Benoîte Gracia Diatewa Gabrielle Ontsira Grâce Kadidja Cléona Nkounkou-Milandou Eliot Prince Galiéni Sounga-Banzouzi Ghislain Armel Mpandzou Jean Robert Mabiala-Babela Paul Macaire Ossou-Nguiet Josué Euberma Diatewa;Dinah Happhia Boubayi Motoula-Latou;Benoîte Gracia Diatewa;Gabrielle Ontsira;Grâce Kadidja Cléona Nkounkou-Milandou;Eliot Prince Galiéni Sounga-Banzouzi;Ghislain Armel Mpandzou;Jean Robert Mabiala-Babela;Paul Macaire Ossou-Nguiet(Neurology Department, University Hospital of Brazzaville, Brazzaville, Republic of Congo;Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Republic of Congo;Neonatology Department, Blanche Gomez Mother and Child Hospital, Brazzaville, Republic of Congo;Neonatology Department, University Hospital of Brazzaville, Brazzaville, Republic of Congo;Neurology Department, Loandjili General Hospital, Pointe Noire, Republic of Congo)

机构地区：[1]Neurology Department, University Hospital of Brazzaville, Brazzaville, Republic of Congo [2]Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Republic of Congo [3]Neonatology Department, Blanche Gomez Mother and Child Hospital, Brazzaville, Republic of Congo [4]Neonatology Department, University Hospital of Brazzaville, Brazzaville, Republic of Congo [5]Neurology Department, Loandjili General Hospital, Pointe Noire, Republic of Congo

出　　处：《Neuroscience & Medicine》2023年第4期63-75,共13页神经系统科学与医药（英文）

摘　　要：Background: Moderate to severe hypoxic-ischemic encephalopathy (HIE) in neonates is often treated with hypothermia. However, some neonates may experience epileptic seizures during therapeutic hypothermia (TH). Data on the electrophysiologic and evolutionary aspects of these seizures are scarce in African countries. Objectives: To determine the types of epileptic seizures caused by HIE in neonates in Brazzaville;to describe the evolution of background EEG activities during TH and rewarming;to report the evolution of epileptic seizures. Methods: This was a cross-sectional, descriptive study conducted from January 2020 to July 2022. It took place in Brazzaville in the Neonatology Department of the Blanche Gomez Mother and Child Hospital. It focused on term neonates suffering from moderate or severe HIE. They were treated with hypothermia combined with phenobarbital for 72 hours. Results: Among 36 neonates meeting inclusion criteria, there were 18 boys and 18 girls. Thirty-one (86.1%) neonates had grade 2 and 5 (13.9%) grade 3 HIE. In our neonates, HIE had induced isolated electrographic seizures (n = 11;30.6%), electroclinical seizures (n = 25;69.4%), and 6 types of background EEG activity. During TH and rewarming, there were 52.8% of patients with improved background EEG activity, 41.7% of patients with unchanged background EEG activity, and 5.5% of patients with worsened background EEG activity. At the end of rewarming, only 9 (25%) patients still had seizures. Conclusion: Isolated electrographic and electroclinical seizures are the only pathological entities found in our studied population. In neonates with moderate HIE, the applied therapeutic strategy positively influences the evolution of both seizures and background EEG activity. On the other hand, in neonates with severe HIE, the same therapeutic strategy is ineffective. .Background: Moderate to severe hypoxic-ischemic encephalopathy (HIE) in neonates is often treated with hypothermia. However, some neonates may experience epileptic seizures during therapeutic hypothermia (TH). Data on the electrophysiologic and evolutionary aspects of these seizures are scarce in African countries. Objectives: To determine the types of epileptic seizures caused by HIE in neonates in Brazzaville;to describe the evolution of background EEG activities during TH and rewarming;to report the evolution of epileptic seizures. Methods: This was a cross-sectional, descriptive study conducted from January 2020 to July 2022. It took place in Brazzaville in the Neonatology Department of the Blanche Gomez Mother and Child Hospital. It focused on term neonates suffering from moderate or severe HIE. They were treated with hypothermia combined with phenobarbital for 72 hours. Results: Among 36 neonates meeting inclusion criteria, there were 18 boys and 18 girls. Thirty-one (86.1%) neonates had grade 2 and 5 (13.9%) grade 3 HIE. In our neonates, HIE had induced isolated electrographic seizures (n = 11;30.6%), electroclinical seizures (n = 25;69.4%), and 6 types of background EEG activity. During TH and rewarming, there were 52.8% of patients with improved background EEG activity, 41.7% of patients with unchanged background EEG activity, and 5.5% of patients with worsened background EEG activity. At the end of rewarming, only 9 (25%) patients still had seizures. Conclusion: Isolated electrographic and electroclinical seizures are the only pathological entities found in our studied population. In neonates with moderate HIE, the applied therapeutic strategy positively influences the evolution of both seizures and background EEG activity. On the other hand, in neonates with severe HIE, the same therapeutic strategy is ineffective. .

关 键 词：Epileptic Seizures NEONATE Hypoxo-Ischemic Encephalopathy Therapeutic Hypothermia Antiepileptic Drugs BRAZZAVILLE 

分 类 号：R72[医药卫生—儿科]