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Previous issue date: 2012-03-14 / Introduction : Neonatal seizures are usually an acute manifestation of central nervous system (CNS) dysfunction. Its incidence in population-based studies ranges from 1-5:1000 live births (Lombroso, 1996) in studies of high-risk population from tertiary hospitals and/or neonatal intensive care units it is significantly higher (Da Silva et al., 2004; Nunes et al., 2008). This study aimed to evaluate the clinical and neurological prognosis of children who had seizures in the neonatal period, checking the incidence and impact of the occurrence of postnatal epilepsy in relation to neuropsychomotor development and quality of sleep.Methods : A cross sectional study was carried out in historical cohort of infants who had seizures confirmed by clinical observation and EEG or video EEG, during hospitalization in the Neonatal Intensive Care Unit of S?o Lucas Hospital, Pontifical Catholic University Hospital of Rio Grande do Sul (PUCRS) in the period from January 2004 to December 2009. The study included 42 neonates, of which it was possible to follow up on 22, which were evaluated when the neuropsychomotor development through the Denver II triage test; sleep habits by the Inventory of Sleep Habits for Preschool Children; occurrence of post neonatal epilepsy by Questionnaire of Neurologic Tracking for Epilepsy (QNT-E) and the neurological diagnostic interview for epilepsy (NDIE).Results : There was no significant difference between children with and without follow-up when compared clinical perinatal data and EEG findings. In the group with follow-up was observed a high percentage of patients who developed epilepsy during the first year of life (45.5%, n = 10). It was observed a predominance of changes in Denver II test in children with epilepsy, where all of them showed abnormal or questionable results (p = 0.001). The inventory of sleep results were higher in children without epilepsy. The average difference of result for the inventory between the groups with and without epilepsy was 13.25 (95% confidence interval = 1.39 to 25.11, p = 0.030).Conclusion : The present study showed high incidence of epilepsy after neonatal crisis and association with indicators of delayed neuropsychomotor development. The sleep habits were more regular and appropriate in children with epilepsy. / Introdu??o : Convuls?es neonatais s?o geralmente uma manifesta??o aguda de disfun??o do sistema nervoso central (SNC). Sua incid?ncia, em estudos de base populacional varia de 1-5:1000 nascidos vivos (Lombroso, 1996), em estudos realizados em popula??es de alto risco provenientes de hospitais terci?rios e/ou Unidades de terapia intensiva neonatal ela ? significativamente superior (Da Silva et al., 2004; Nunes et al., 2008). O presente estudo teve como objetivo avaliar o progn?stico cl?nico-neurol?gico de crian?as que apresentaram crises convulsivas no per?odo neonatal, verificando a incid?ncia e o impacto da ocorr?ncia de epilepsia p?s-natal em rela??o ao desenvolvimento neuropsicomotor e qualidade do sono.M?todos : Realizou-se estudo transversal em coorte hist?rica de rec?m-nascidos que apresentaram crises convulsivas confirmadas pela observa??o cl?nica e EEG ou v?deo-EEG, durante interna??o na Unidade de Terapia Intensiva Neonatal do Hospital Universit?rio da Pontif?cia Universidade Cat?lica do Rio Grande do Sul (PUCRS), no per?odo entre Janeiro de 2004 a Dezembro de 2009. Foram inclu?das no estudo 42 neonatos, dos quais foi poss?vel obter seguimento em 22, que foram avaliadas quando ao desenvolvimento neuropsicomotor atrav?s do teste de triagem de Denver II; h?bitos do sono pelo Invent?rio dos H?bitos de Sono para Crian?as Pr?-escolares; ocorr?ncia de epilepsia p?s-neonatal pelo Question?rio de Rastreamento Neurol?gico para Epilepsia (QRN-E) e pela Entrevista Diagn?stica Neurol?gica para Epilepsia (EDN-E).Resultados : N?o houve diferen?a significativa entre as crian?as com e sem seguimento quando comparados os dados cl?nicos perinatais e achados do EEG. No grupo com seguimento observou-se um elevado percentual de pacientes que desenvolveram epilepsia durante os primeiros anos de vida (45,5%, n=10). Foi observado predom?nio de altera??es no teste de Denver II nas crian?as com epilepsia, onde todas apresentavam resultado anormal ou question?vel (p=0,001). Os escores do invent?rio do sono foram maiores nas crian?as sem epilepsia. A diferen?a m?dia do escore para o invent?rio entre os grupos com e sem epilepsia foi de 13,25 (intervalo de confian?a 95% = 1,39 25,11; p=0,030).Conclus?o : o presente estudo evidenciou elevada incid?ncia de epilepsia ap?s crises neonatais e associa??o com indicadores de atraso no desenvolvimento neuropsicomotor. Os h?bitos de sono, foram mais regulares e adequados nas crian?as com epilepsia quando comparadas as sem epilepsia.
Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/1693 |
Date | 14 March 2012 |
Creators | Baggio, Bruna Finato |
Contributors | Nunes, Magda Lahorgue |
Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de, PUCRS, BR, Faculdade de Medicina |
Source Sets | IBICT Brazilian ETDs |
Language | Portuguese |
Detected Language | English |
Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
Format | application/pdf |
Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
Rights | info:eu-repo/semantics/openAccess |
Relation | 7620745074616285884, 500, 600, -8624664729441623247 |
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