Neonatal brain MRI and short-term outcomes after acute provoked seizures

Yi Li; Aaron Scheffler; Anthony James Barkovich; Taeun Chang; Catherine J Chu; Shavonne L Massey; Nicholas S Abend; Monica E Lemmon; Cameron Thomas; Adam Numis; Linda S Franck; Elizabeth Rogers; Andrew Callen; Charles E McCulloch; Renée A Shellhaas; Hannah C Glass

doi:10.1038/s41372-023-01723-3

Neonatal brain MRI and short-term outcomes after acute provoked seizures

J Perinatol. 2023 Nov;43(11):1392-1397. doi: 10.1038/s41372-023-01723-3. Epub 2023 Jul 15.

Authors

Yi Li¹, Aaron Scheffler², Anthony James Barkovich³, Taeun Chang⁴, Catherine J Chu⁵, Shavonne L Massey⁶, Nicholas S Abend^{6

7}, Monica E Lemmon⁸, Cameron Thomas⁹, Adam Numis¹⁰, Linda S Franck¹¹, Elizabeth Rogers¹², Andrew Callen¹³, Charles E McCulloch², Renée A Shellhaas¹⁴, Hannah C Glass^{2

10

12}

Affiliations

¹ Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA. yi.li@ucsf.edu.
² Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
³ Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.
⁴ Department of Neurology, Children's National Hospital, George Washington University School of Medicine, Washington, DC, USA.
⁵ Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
⁶ Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
⁷ Departments of Anesthesia & Critical Care Medicine, Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
⁸ Department of Pediatrics and Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
⁹ Department of Pediatrics, University of Cincinnati and Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
¹⁰ Department of Neurology and Weill Institute for Neuroscience, University of California San Francisco, San Francisco, CA, USA.
¹¹ Department of Family Health Care Nursing, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, CA, USA.
¹² Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, CA, USA.
¹³ Department of Radiology, University of Colorado Denver School of Medicine, Denver, CO, USA.
¹⁴ Division of Pediatric Neurology, Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA.

Abstract

Objective: We investigated how diagnosis and injury location on neonatal brain MRI following onset of acute provoked seizures was associated with short term outcome.

Study design: A multicenter cohort of neonates with acute provoked seizures enrolled in the Neonatal Seizure Registry. MRIs were centrally evaluated by a neuroradiologist for location of injury and radiologic diagnosis. Clinical outcomes were determined by chart review. Multivariate logistic regression was used to examine the association between MRI findings and outcomes.

Results: Among 236 newborns with MRI at median age 4 days (IQR 3-8), 91% had abnormal MRI. Radiologic diagnoses of intracranial hemorrhage (OR 3.2 [1.6-6.5], p < 0.001) and hypoxic-ischemic encephalopathy (OR 2.7 [1.4-5.4], p < 0.003) were associated with high seizure burden. Radiologic signs of intracranial infection were associated with abnormal neurologic examination at discharge (OR 3.9 [1.3-11.6], p < 0.01).

Conclusion: Findings on initial MRI can help with expectant counseling on short-term outcomes following acute provoked neonatal seizures.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Brain / diagnostic imaging
Electroencephalography
Epilepsy*
Humans
Hypoxia-Ischemia, Brain* / complications
Hypoxia-Ischemia, Brain* / diagnostic imaging
Infant, Newborn
Infant, Newborn, Diseases*
Magnetic Resonance Imaging
Neuroimaging
Seizures / diagnostic imaging