Defining neonatal status epilepticus: A scoping review from the ILAE neonatal task force
Abstract Objective To review the available literature concerning the definition of neonatal status epilepticus (SE) and/or seizure burden. Methods The International League Against Epilepsy Neonatal Task Force performed a scoping review of the definitions of neonatal SE. Following a systematic litera...
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Wiley
2025-02-01
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| Series: | Epilepsia Open |
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| Online Access: | https://doi.org/10.1002/epi4.13090 |
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| author | Magda L. Nunes Elissa G. Yozawitz Courtney J. Wusthoff Renée A. Shellhaas Efraín Olivas‐Peña Jo M. Wilmshurst Ronit M. Pressler Chahnez C. Triki Hans Hartmann Terrie Inder Geraldine B. Boylan Kette Valente Solomon L. Moshe Eli M. Mizrahi Nicholas S. Abend |
| author_facet | Magda L. Nunes Elissa G. Yozawitz Courtney J. Wusthoff Renée A. Shellhaas Efraín Olivas‐Peña Jo M. Wilmshurst Ronit M. Pressler Chahnez C. Triki Hans Hartmann Terrie Inder Geraldine B. Boylan Kette Valente Solomon L. Moshe Eli M. Mizrahi Nicholas S. Abend |
| author_sort | Magda L. Nunes |
| collection | DOAJ |
| description | Abstract Objective To review the available literature concerning the definition of neonatal status epilepticus (SE) and/or seizure burden. Methods The International League Against Epilepsy Neonatal Task Force performed a scoping review of the definitions of neonatal SE. Following a systematic literature review, articles were screened and data were abstracted regarding: (1) article characteristics (author identification, publication year, journal name, digital object identifier, title, objective, and study design); (2) cohort characteristics (sample size, gestational age, seizure etiology); (3) definition of SE and/or seizure burden; and (4) the method used to identify and classify SE, including routine EEG (EEG), continuous EEG monitoring (cEEG), amplitude‐integrated EEG (aEEG), or clinical features. Results The scoping review yielded 44 articles containing a definition of neonatal SE. Studies mainly included infants with hypoxic–ischemic encephalopathy or neonates considered at risk for seizures. SE identification and classification most often relied on cEEG. The majority of studies based the definition of SE on seizure duration, including summed duration of seizures comprising ≥50% of any 1‐h epoch, recurrent seizures for >50% of the total recording time, or either electrographic seizures lasting >30 min and/or repeated electrographic seizures totaling >50% in any 1‐h period. Seizure burden was reported in 20 studies, and the most commonly used approach assessed total seizure burden, defined as total duration of EEG seizures in minutes. Sixteen studies assessed the relationship between seizure burden and outcomes, and most identified a significant association between higher seizure burden and unfavorable outcomes. Significance This scoping review demonstrates a substantial variation in neonatal SE definitions across the literature. The most common definitions were based around a 30‐min seizure duration criterion, but evidence was insufficient to support that 30 min was a cutoff defining prolonged seizures or that seizures exceeding this burden were more likely to be pharmacoresistant or associated with worse outcomes. As a next step, the Neonatal Task Force intends to develop a standardized approach to assessing and describing neonatal seizure burden and defining neonatal SE. Plain Language Summary Prolonged seizures are a neurologic emergency, if untreated, can lead to permanent injury or death. In adults and children, seizures lasting longer than 30 min are believed to cause brain damage. However, it is not clear if this definition can be applied to neonates. The International League Against Epilepsy Neonatal Taskforce performed a scoping literature review which identified 44 articles containing a definition of neonatal status epilepticus. In this article, the authors reviewed the current used definitions for prolonged seizures in neonates to establish a relationship between seizure duration and neurological outcome. As a next step, the Neonatal Task Force intends to develop a standardized approach to assessing and describing neonatal seizure burden and defining neonatal SE. |
| format | Article |
| id | doaj-art-e9bf3054b6b04f66ab2ceb922a0accff |
| institution | Kabale University |
| issn | 2470-9239 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wiley |
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| series | Epilepsia Open |
| spelling | doaj-art-e9bf3054b6b04f66ab2ceb922a0accff2025-02-07T09:12:45ZengWileyEpilepsia Open2470-92392025-02-01101405410.1002/epi4.13090Defining neonatal status epilepticus: A scoping review from the ILAE neonatal task forceMagda L. Nunes0Elissa G. Yozawitz1Courtney J. Wusthoff2Renée A. Shellhaas3Efraín Olivas‐Peña4Jo M. Wilmshurst5Ronit M. Pressler6Chahnez C. Triki7Hans Hartmann8Terrie Inder9Geraldine B. Boylan10Kette Valente11Solomon L. Moshe12Eli M. Mizrahi13Nicholas S. Abend14School of Medicine and Brain Institute (BraIns) Pontifical Catholic University of Rio Grande Do Sul Porto Alegre Rio Grande do Sul BrazilIsabelle Rapin Division of Child Neurology of the Saul R Korey Department of Neurology and Pediatrics, Albert Einstein College of Medicine Montefiore Medical Center Bronx New York USADepartment of Neurology University of California, Davis Sacramento California USADivision of Pediatric Neurology, Department of Neurology Washington University in St Louis School of Medicine St Louis Missouri USADepartment of Neurosciences, National Institute of Perinatology, Mexico City, Mexico. Department of Pediatrics Women's Hospital Yautepec Morelos MexicoDepartment of Paediatric Neurology, Red Cross War Memorial Children's Hospital, Neuroscience Institute University of Cape Town Cape Town South AfricaClinical Neuroscience, UCL GOS Institute of Child Health and Department of Clinical Neurophysiology Great Ormond Street Hospital for Children NHS Foundation Trust London UKChild Neurology Department Hedi Chaker Hospital, LR19ES15, University of Sfax Sfax TunisiaDepartment of Pediatric Kidney, Liver, Metabolic and Neurological Diseases Hannover Medical School Hannover GermanyDepartment of Pediatrics University of California, Irvine; Director, Center for Newborn Research, Children's Hospital of Orange County California USAINFANT Research Centre and Department of Paediatrics & Child Health University College Cork Cork IrelandDepartment of Psychiatry and Pediatrics, Research Center for Complex and Rare Epilepsies Faculty of Medicine of the University of São Paulo (FMUSP) São Paulo BrazilLaboratory of Clinical Neurophysiology and LIM 21, Department of Psychiatry Clinics Hospital, University of São Paulo (HC FMUSP) São Paulo BrazilDepartment of Neurology and Pediatrics Baylor College of Medicine Houston Texas USADepartment of Neurology and Pediatrics Children's Hospital of Philadelphia and University of Pennsylvania Philadelphia Pennsylvania USAAbstract Objective To review the available literature concerning the definition of neonatal status epilepticus (SE) and/or seizure burden. Methods The International League Against Epilepsy Neonatal Task Force performed a scoping review of the definitions of neonatal SE. Following a systematic literature review, articles were screened and data were abstracted regarding: (1) article characteristics (author identification, publication year, journal name, digital object identifier, title, objective, and study design); (2) cohort characteristics (sample size, gestational age, seizure etiology); (3) definition of SE and/or seizure burden; and (4) the method used to identify and classify SE, including routine EEG (EEG), continuous EEG monitoring (cEEG), amplitude‐integrated EEG (aEEG), or clinical features. Results The scoping review yielded 44 articles containing a definition of neonatal SE. Studies mainly included infants with hypoxic–ischemic encephalopathy or neonates considered at risk for seizures. SE identification and classification most often relied on cEEG. The majority of studies based the definition of SE on seizure duration, including summed duration of seizures comprising ≥50% of any 1‐h epoch, recurrent seizures for >50% of the total recording time, or either electrographic seizures lasting >30 min and/or repeated electrographic seizures totaling >50% in any 1‐h period. Seizure burden was reported in 20 studies, and the most commonly used approach assessed total seizure burden, defined as total duration of EEG seizures in minutes. Sixteen studies assessed the relationship between seizure burden and outcomes, and most identified a significant association between higher seizure burden and unfavorable outcomes. Significance This scoping review demonstrates a substantial variation in neonatal SE definitions across the literature. The most common definitions were based around a 30‐min seizure duration criterion, but evidence was insufficient to support that 30 min was a cutoff defining prolonged seizures or that seizures exceeding this burden were more likely to be pharmacoresistant or associated with worse outcomes. As a next step, the Neonatal Task Force intends to develop a standardized approach to assessing and describing neonatal seizure burden and defining neonatal SE. Plain Language Summary Prolonged seizures are a neurologic emergency, if untreated, can lead to permanent injury or death. In adults and children, seizures lasting longer than 30 min are believed to cause brain damage. However, it is not clear if this definition can be applied to neonates. The International League Against Epilepsy Neonatal Taskforce performed a scoping literature review which identified 44 articles containing a definition of neonatal status epilepticus. In this article, the authors reviewed the current used definitions for prolonged seizures in neonates to establish a relationship between seizure duration and neurological outcome. As a next step, the Neonatal Task Force intends to develop a standardized approach to assessing and describing neonatal seizure burden and defining neonatal SE.https://doi.org/10.1002/epi4.13090neonatalneurocritical careoutcomeseizure burdenseizuresstatus epilepticus |
| spellingShingle | Magda L. Nunes Elissa G. Yozawitz Courtney J. Wusthoff Renée A. Shellhaas Efraín Olivas‐Peña Jo M. Wilmshurst Ronit M. Pressler Chahnez C. Triki Hans Hartmann Terrie Inder Geraldine B. Boylan Kette Valente Solomon L. Moshe Eli M. Mizrahi Nicholas S. Abend Defining neonatal status epilepticus: A scoping review from the ILAE neonatal task force Epilepsia Open neonatal neurocritical care outcome seizure burden seizures status epilepticus |
| title | Defining neonatal status epilepticus: A scoping review from the ILAE neonatal task force |
| title_full | Defining neonatal status epilepticus: A scoping review from the ILAE neonatal task force |
| title_fullStr | Defining neonatal status epilepticus: A scoping review from the ILAE neonatal task force |
| title_full_unstemmed | Defining neonatal status epilepticus: A scoping review from the ILAE neonatal task force |
| title_short | Defining neonatal status epilepticus: A scoping review from the ILAE neonatal task force |
| title_sort | defining neonatal status epilepticus a scoping review from the ilae neonatal task force |
| topic | neonatal neurocritical care outcome seizure burden seizures status epilepticus |
| url | https://doi.org/10.1002/epi4.13090 |
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