Abstracts

Rationale: Newborns with congenital heart disease have a high risk of seizures, associated to developmental delay, cerebral palsy, and epilepsy. Methods: Observational retrospective descriptive study of newborns with CHD with seizures admitted between June 2005-November 2011 at the Italian Hospital Neonatology Unit. Results: 116 consecutive newborns with seizures were included. We analyzed 29 (25%) with CHD. Median gestational age was 38 weeks (30-40wk.) and birth weight 3100gr (1200 - 4375). All patients had symptomatic seizures, associated to: hemodynamic decompensation 51.7% (n=15), sepsis 17,2% (n=5) and stroke, el 6,9% (n=2). Neurological exam was normal in 24.3% (n=7). 48.3% (n=14) had only one seizures, and 4p. (14.3%) had status epilepticus. EEGs were abnormal in 21 p. (72.4%). 10 (35,7%) had focal paroxysms, 6 (21.4%) low amplitud, 4 (13.8%) minimal alterations and 1p. had burst suppression. 9p. 31% died, due to hemodynamic decompensation. 9/9 had an abnormal EEG, (p: 0.027) and an abnormal neurological exam, p:0.05. 4/9, 44% presented status epilepticus. P: 0.0053 At 6 months, 2 more newborns died and 2 had refractory epilepsy. 6/18 patients had a normal neurological exam. 6/18 had a normal neonatal neurological exam, 4 (66%) had had only one seizure and 5 (83.3%) a normal EEG p:0.025 . Conclusions: In this study population we observed a high mortality and adverse neurological outcome. The strongest predictors were abnormal EEG, abnormal neurological exam and status epilepticus. Future studies of neurologic outcome and neuroprotective strategies are needed to improve neurodevelopmental outcomes.