live births, and risk estimates were consistently higher in low-birth-weight infants (relative risk of 3.9). The overall risk of neonatal seizures in the United States was 2. The incidence of seizures is highest during the neonatal period. Neonatal seizures are the most characteristic sign of neurological disease and the most frequent neurological events during the neonatal period (babies less than 28 days old), often reflecting a variety of different pre-, peri-, or postnatal disorders of the central nervous system (CNS). Their clinical manifestations are myoclonic or tonic seizures, which represent the expression of the underlying pathology and correlate with degree of brain damage. In the present chapter we review the genes involved in EIEE and EME including their possible mechanisms of action, particularly via GABAegic interneurons. These findings could explain the occurrence of severe epileptic encephalopathy with a burst-suppression pattern and represent a continuum of progressive pathology.
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Both mutations in the ARX gene for EIEE (OMIM 308350) and disruption in the neuregulin receptor ErbB4 for EME (OMIM 609304) impair interneuron migration and alter the number of GABAergic interneurons in the postnatal cortex. However, the distinction between those two pathologies is not always easy due to clinical and etiological overlap. The critical difference lies in their presumed etiologies and the prevailing clinical seizure type at onset: EIEE (known as Ohtahara syndrome) usually manifests with tonic seizures, while EME is mainly associated with myoclonic seizures. The International League Against Epilepsy classifies both of them as generalized symptomatic epilepsies of nonspecific etiology, characterized by early onset, presence of burst-suppression EEG pattern and serious prognosis. PMID: 34812237 | PMC: PMC8593491 | DOI: 10.6515/ACS.202111_37(6).Early infantile epileptic encephalopathy (EIEE) and early myoclonic encephalopathy (EME) are catastrophic epilepsies starting in the neonatal period. Moreover, the continuous pattern, but not the status epilepticus or burst suppression patterns, could predict mid-term good neurologic function.ĬONCLUSIONS: aEEG can be used to predict neurologic outcomes based on the recordings’ parameters and patterns in unconscious adults who have experienced a cardiac collapse, resuscitation, and return of spontaneous circulation. The four voltage parameters (minimum, maximum, span, average) of the aEEG recordings in the good neurologic function groups were significantly higher than in the poor group. RESULTS: Nineteen patients were in the good neurologic function group, and 23 were in the poor group.
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All patients received an aEEG examination within 24 h after a return of spontaneous circulation, and the parameters and patterns of aEEG recordings were compared. The primary outcome was the best neurologic outcome within 6 months after resuscitation, and the registered patients were divided into two groups based on the Cerebral Performance Category (CPC) scale (CPC 1-2, good neurologic function group CPC 3-5, poor neurologic function group). These patients were admitted to the Coronary Intensive Care Unit due to cardiogenic cardiac arrest. METHODS: Forty-two consecutive patients experiencing cardiac arrest were retrospectively enrolled, and a return of spontaneous circulation was achieved in all cases. OBJECTIVES: To assess the prognostic value of aEEG during the post-resuscitation period of adult cardiogenic cardiac arrest, comatose survivors were monitored within 24 h of a return of spontaneous circulation using aEEG.
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doi: 10.6515/ACS.202111_37(6).20210630B.īACKGROUND: Amplitude-integrated electroencephalography (aEEG) has been used as a tool to recognize brain activity in children with hypoxic encephalopathy.