Objective:

Acute brain injury is a frequent perinatal neurologic complication that can involve the cerebellum. Although short-term outcomes of infants with neonatal cerebellar injury are well described, neurologic sequelae in older children are underreported. Here, we describe epilepsy-related outcomes in young children who suffered from neonatal cerebellar injuries.

Methods:

In-house automated software identified patients with neonatal brain injuries who were evaluated at our institution both as neonates (≤28 days) and as children (≥1 year). Neonatal hospital course, neuroimaging, and outcomes related to epilepsy were reviewed from the medical record. Patients were stratified into 2 groups based on neonatal brain injuries: those with cerebellar injury and those without cerebellar involvement.

Results:

Of the 282 neonates followed through childhood over the decade-long study period, 33 (12%) experienced neonatal brain injury. All 33 cases involved supratentorial injury, and 5 (15%) also included cerebellar injury. The development of epilepsy was significantly less likely in the group with cerebellar involvement (40%) compared to that with cerebellar sparing (82%; P = 0.043). In some cases, children with cerebellum-sparing injuries required admission for seizure control and developed drug-resistant epilepsy as well as status epilepticus. These outcomes occurred less frequently in the group with cerebellar involvement.

Conclusions:

Epilepsy-related sequelae may occur less frequently when the cerebellum is involved in neonatal brain injury. Larger prospective studies are needed to clarify how cerebellocortical networks impact functional brain connectivity and epilepsy longitudinally.

中文翻译：

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新生儿小脑损伤患儿的癫痫相关结局

客观的：

急性脑损伤是一种常见的围产期神经系统并发症，可累及小脑。尽管新生儿小脑损伤婴儿的短期结果得到了很好的描述，但大龄儿童的神经系统后遗症却被低估了。在这里，我们描述了患有新生儿小脑损伤的幼儿的癫痫相关结果。

方法：

内部自动化软件将在我们机构接受评估的新生儿脑损伤患者识别为新生儿（≤28 天）和儿童（≥1 岁）。从病历中回顾了新生儿医院课程、神经影像学和与癫痫相关的结果。根据新生儿脑损伤将患者分为两组：小脑损伤组和小脑未受累组。

结果：

在长达十年的研究期间，282 名新生儿经历了童年，其中 33 名 (12%) 经历了新生儿脑损伤。33 例均涉及幕上损伤，5 例（15%）还包括小脑损伤。与保留小脑的组 (82%; P = 0.043)相比，小脑受累组 (40%) 发生癫痫的可能性显着降低。在某些情况下，保留小脑损伤的儿童需要入院以控制癫痫发作，并发展为耐药性癫痫和癫痫持续状态。这些结果在小脑受累组中较少发生。

结论：

当小脑涉及新生儿脑损伤时，癫痫相关后遗症的发生频率可能​​会降低。需要更大规模的前瞻性研究来阐明小脑皮质网络如何纵向影响功能性大脑连接和癫痫。