Epileptic Seizures in Neonates Treated with Hypothermia for Hypoxo-Ischemic Encephalopathy in Brazzaville, Congo: Types and Evolution ()
Author(s)
Josué Euberma Diatewa1,2*,
Dinah Happhia Boubayi Motoula-Latou1,2,
Benoîte Gracia Diatewa3,
Gabrielle Ontsira4,
Grâce Kadidja Cléona Nkounkou-Milandou3,
Eliot Prince Galiéni Sounga-Banzouzi2,5,
Ghislain Armel Mpandzou1,2,
Jean Robert Mabiala-Babela2,3,
Paul Macaire Ossou-Nguiet1,2
Affiliation(s)
1Neurology Department, University Hospital of Brazzaville, Brazzaville, Republic of Congo.
2Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Republic of Congo.
3Neonatology Department, Blanche Gomez Mother and Child Hospital, Brazzaville, Republic of Congo.
4Neonatology Department, University Hospital of Brazzaville, Brazzaville, Republic of Congo.
5Neurology Department, Loandjili General Hospital, Pointe Noire, Republic of Congo.
ABSTRACT
Background: Moderate to severe hypoxic-ischemic encephalopathy (HIE) in neonates is often treated with hypothermia. However,
some neonates may experience epileptic seizures during therapeutic hypothermia
(TH). Data on the electrophysiologic and
evolutionary aspects of these seizures are scarce in African countries. Objectives: To determine the types of epileptic seizures caused by HIE in neonates in
Brazzaville; to describe the evolution of background EEG activities during TH
and rewarming; to report the evolution of epileptic seizures. Methods: This was a cross-sectional, descriptive study conducted from January 2020 to
July 2022. It took place in Brazzaville in the Neonatology Department of the
Blanche Gomez Mother and Child Hospital. It focused on term neonates suffering
from moderate or severe HIE. They were treated with hypothermia combined with phenobarbital for 72 hours. Results: Among 36 neonates meeting inclusion criteria, there were 18 boys and 18 girls.
Thirty-one (86.1%) neonates had grade 2 and 5 (13.9%) grade 3 HIE. In our
neonates, HIE had induced isolated electrographic seizures (n = 11; 30.6%),
electroclinical seizures (n = 25; 69.4%), and 6 types of background EEG
activity. During TH and rewarming, there
were 52.8% of patients with improved background EEG activity, 41.7% of
patients with unchanged background EEG activity, and 5.5% of patients with
worsened background EEG activity. At the end of rewarming, only 9 (25%)
patients still had seizures. Conclusion: Isolated electrographic and
electroclinical seizures are the only pathological entities found in our
studied population. In neonates with moderate HIE, the applied therapeutic
strategy positively influences the evolution of both seizures and background EEG activity. On the other hand, in
neonates with severe HIE, the same therapeutic strategy is ineffective.
Share and Cite:
Euberma Diatewa, J. , Boubayi Motoula-Latou, D. , Gracia Diatewa, B. , Ontsira, G. , Nkounkou-Milandou, G. , Galiéni Sounga-Banzouzi, E. , Armel Mpandzou, G. , Mabiala-Babela, J. and Ossou-Nguiet, P. (2023) Epileptic Seizures in Neonates Treated with Hypothermia for Hypoxo-Ischemic Encephalopathy in Brazzaville, Congo: Types and Evolution.
Neuroscience and Medicine,
14, 63-75. doi:
10.4236/nm.2023.144005.
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