Abstracts

RATIONALE Intellectual quotient may be affected negatively in children with epilepsy but data regard the early mental development in infants with epilepsy are scare(1,2).The goal of the study was to determine the mental development of infants at corrected age of 24 months at high risk of impaired development and epilepsy attributed to Peri-natal insults discharged from Neonatal Intensive Care Unit (NICU). METHODS We included in this prospective cohort newborns at risk for neurodevelopmental abnormalities. Follow-up visits were performed after the subjects were discharged from NICU.Mental Development Index (MDI) of infants was evaluated through the Bayley Scales of Infant Development (BSID-II) when they were at corrected age of 24 months. One-sample Kolmogorov-Smirnov test was performed to analyze the normal distribution of the sample. ANOVA and Tukey HSD post-hoc test were used for statistical analysis. A chi-squared test was performed to determine the association or independence between neonatal seizures and epilepsy attributed to peri-natal insults. Differences were considered to be significant when the p value was <0.05. MDIs from 15 healthy infants were used as control data (HIgroup). RESULTS Thirty eight infants were followed-up through an early intervention programme (neurohabilitation therapy). 13 (34%) of them had neonatal seizures (NSgroup); 12 (32%) developed epilepsy attributed to peri-natal insults (Egroup), and 13 (34%) had increased risk for long-term neurodevelopmental deficits but no neonatal seizures background or epilepsy(RFgroup).The Kolmogorov-Smirnoff test showed normal distribution in the sample (Z=1.162, p=0.134); homogeneity of variance showed no differences between the groups (p=0.459) so it was assumed that the variance within each of the groups was equal. Since chi squared value was 6.2 (p<0.02) it was accepted that epilepsy attributed to perinatal insults was independent of neonatal seizures. MDI showed differences between the groups (p=0.004) and epileptic infants had the worst MDI; when Egroup and NSgroup were compared with HIgroup, statistical differences were seen (p=0.008 and p=0.014, respectively).However, there were no differences between RFgroup and HIgroup and between Egroup and NSgroup. CONCLUSIONS Infants at risk of impaired development and neonatal seizures background or epilepsy attributed to peri-natal insults may have poor prognosis in mental development(3,4); epilepsy attributed to peri-natal insults is independent of neonatal seizures, but both of them have a negative effect on mental development despite infants received neurohabilitation. It was demonstrated that seizures had a deleterious effect on early cognition. Cognitive development follow-up in these infants is mandatory as soon as they have been discharged from NICU and early cognitive interventions should be considered in them. Other risk factors for long-term neurodevelopmental deficits might not be as ominous as neonatal seizures or epilepsy on cognition.