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

Yi Li, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA. yi.li@ucsf.edu.
Aaron Scheffler, Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
Anthony James Barkovich, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.
Taeun Chang, Department of Neurology, Children's National Hospital, George Washington University School of Medicine, Washington, DC, USA.
Catherine J. Chu, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Shavonne L. Massey, Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Nicholas S. Abend, Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Monica E. Lemmon, Department of Pediatrics and Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
Cameron Thomas, Department of Pediatrics, University of Cincinnati and Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Adam Numis, Department of Neurology and Weill Institute for Neuroscience, University of California San Francisco, San Francisco, CA, USA.
Linda S. Franck, Department of Family Health Care Nursing, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, CA, USA.
Elizabeth Rogers, Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, CA, USA.
Andrew Callen, Department of Radiology, University of Colorado Denver School of Medicine, Denver, CO, USA.
Charles E. McCulloch, Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
Renée A. Shellhaas, Division of Pediatric Neurology, Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA.
Hannah C. Glass, Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.

Document Type

Journal Article

Publication Date

7-15-2023

Journal

Journal of perinatology : official journal of the California Perinatal Association

DOI

10.1038/s41372-023-01723-3

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.

Department

Neurology

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