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

Abstract

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.