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Restricted diffusion of the callosal splenium is highly specific for seizures in neonates

BACKGROUND: To determine whether restricted diffusion of the callosal splenium is specific for seizure activity in neonates. METHODS: We performed a retrospective chart review of 123 neonates who had a diagnosis of hypoxic ischemic encephalopathy (HIE) who underwent therapeutic cooling and had magne...

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Autores principales: Nguyen, Linda, Chen, Dillon Y., Vinocur, Daniel N., Gold, Jeffrey J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9724331/
https://www.ncbi.nlm.nih.gov/pubmed/36471320
http://dx.doi.org/10.1186/s12883-022-02984-9
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author Nguyen, Linda
Chen, Dillon Y.
Vinocur, Daniel N.
Gold, Jeffrey J.
author_facet Nguyen, Linda
Chen, Dillon Y.
Vinocur, Daniel N.
Gold, Jeffrey J.
author_sort Nguyen, Linda
collection PubMed
description BACKGROUND: To determine whether restricted diffusion of the callosal splenium is specific for seizure activity in neonates. METHODS: We performed a retrospective chart review of 123 neonates who had a diagnosis of hypoxic ischemic encephalopathy (HIE) who underwent therapeutic cooling and had magnetic resonance imaging (MRI) within the first 10 days of life. The regions examined for injury include the callosal splenium, cortex, deep gray matter, and subcortical white matter. Neurodevelopmental outcomes were secondarily assessed using the Bayley Scales of Infant Development at 12 to 18 months of age and > 18 months of age. APGAR scores and pH, two important markers of hypoxia/ischemia and encephalopathy, were also analyzed in relation to these outcomes. RESULTS: Approximately 41% of the neonates had at least one abnormal region on brain MRI, and 21% had abnormal signal in the splenium. Clinical and/or electrographic seizures were documented in 32%. Changes in the splenium had a sensitivity of 54%, specificity of 94%, and positive predictive value of 81% for seizure presence. The presence of seizures and splenium lesion was associated poor developmental outcomes at 12 to 18 months of age. APGAR scores at 10 minutes, but not lowest pH was associated with splenial changes. CONCLUSIONS: Restricted diffusion of the callosal splenium is specific for recent seizures in neonates with HIE. Seizures and splenial lesion represent risk factors for poor neurodevelopmental outcomes. Child neurologists and neonatologists should consider splenial signal abnormality in their assessment of neonates at risk for seizures and counsel families about likely outcomes accordingly.
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spelling pubmed-97243312022-12-07 Restricted diffusion of the callosal splenium is highly specific for seizures in neonates Nguyen, Linda Chen, Dillon Y. Vinocur, Daniel N. Gold, Jeffrey J. BMC Neurol Research BACKGROUND: To determine whether restricted diffusion of the callosal splenium is specific for seizure activity in neonates. METHODS: We performed a retrospective chart review of 123 neonates who had a diagnosis of hypoxic ischemic encephalopathy (HIE) who underwent therapeutic cooling and had magnetic resonance imaging (MRI) within the first 10 days of life. The regions examined for injury include the callosal splenium, cortex, deep gray matter, and subcortical white matter. Neurodevelopmental outcomes were secondarily assessed using the Bayley Scales of Infant Development at 12 to 18 months of age and > 18 months of age. APGAR scores and pH, two important markers of hypoxia/ischemia and encephalopathy, were also analyzed in relation to these outcomes. RESULTS: Approximately 41% of the neonates had at least one abnormal region on brain MRI, and 21% had abnormal signal in the splenium. Clinical and/or electrographic seizures were documented in 32%. Changes in the splenium had a sensitivity of 54%, specificity of 94%, and positive predictive value of 81% for seizure presence. The presence of seizures and splenium lesion was associated poor developmental outcomes at 12 to 18 months of age. APGAR scores at 10 minutes, but not lowest pH was associated with splenial changes. CONCLUSIONS: Restricted diffusion of the callosal splenium is specific for recent seizures in neonates with HIE. Seizures and splenial lesion represent risk factors for poor neurodevelopmental outcomes. Child neurologists and neonatologists should consider splenial signal abnormality in their assessment of neonates at risk for seizures and counsel families about likely outcomes accordingly. BioMed Central 2022-12-06 /pmc/articles/PMC9724331/ /pubmed/36471320 http://dx.doi.org/10.1186/s12883-022-02984-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Nguyen, Linda
Chen, Dillon Y.
Vinocur, Daniel N.
Gold, Jeffrey J.
Restricted diffusion of the callosal splenium is highly specific for seizures in neonates
title Restricted diffusion of the callosal splenium is highly specific for seizures in neonates
title_full Restricted diffusion of the callosal splenium is highly specific for seizures in neonates
title_fullStr Restricted diffusion of the callosal splenium is highly specific for seizures in neonates
title_full_unstemmed Restricted diffusion of the callosal splenium is highly specific for seizures in neonates
title_short Restricted diffusion of the callosal splenium is highly specific for seizures in neonates
title_sort restricted diffusion of the callosal splenium is highly specific for seizures in neonates
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9724331/
https://www.ncbi.nlm.nih.gov/pubmed/36471320
http://dx.doi.org/10.1186/s12883-022-02984-9
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