[P1-78] Clinical Features of Epileptic Apnea Occurring in Early Postnatal Periods in Trisomy 18.
[Introduction] Central apnea is sometimes observed in trisomy 18. We experienced several cases of trisomy 18 showing epileptic apnea in early postnatal periods, raising the possibility that epileptic apnea is not infrequent in trisomy 18, particularly in neonatal period.
[Methods] We retrospectively analysed cases of trisomy 18 diagnosed with karyotyping who were admitted to NICU in The University of Tokyo Hospital and in Ohta General Nishinouchi Hospital from 11/1/2009 to 30/9/2016. The diagnosis of epileptic apnea required positive ictal activities on conventional or amplitude-integrated EEG associated with apnea. Individuals who died within 24h, or who had additional chromosomal abnormality were excluded.
[Results] Eighteen cases met the above criteria. Epileptic apnea was found in 7/18 (39%) patients and diagnosed in postnatal days 1-60 (median 6 days). PB was effective in all of them (in combination with LEV in one patient). During the observation period, the mortality was analyzed, regarding the complication of epileptic apnea. Presence of epileptic apnea was significantly associated with earlier mortality (p = 0.044 by Logrank test).
[Discussion] Epileptic apnea in trisomy 18 may be a common and an underrecognized manifestation that often occurs in early postnatal period. Though easily controlled with antiepileptic medications, its presence may be associated with poorer prognosis.
[Methods] We retrospectively analysed cases of trisomy 18 diagnosed with karyotyping who were admitted to NICU in The University of Tokyo Hospital and in Ohta General Nishinouchi Hospital from 11/1/2009 to 30/9/2016. The diagnosis of epileptic apnea required positive ictal activities on conventional or amplitude-integrated EEG associated with apnea. Individuals who died within 24h, or who had additional chromosomal abnormality were excluded.
[Results] Eighteen cases met the above criteria. Epileptic apnea was found in 7/18 (39%) patients and diagnosed in postnatal days 1-60 (median 6 days). PB was effective in all of them (in combination with LEV in one patient). During the observation period, the mortality was analyzed, regarding the complication of epileptic apnea. Presence of epileptic apnea was significantly associated with earlier mortality (p = 0.044 by Logrank test).
[Discussion] Epileptic apnea in trisomy 18 may be a common and an underrecognized manifestation that often occurs in early postnatal period. Though easily controlled with antiepileptic medications, its presence may be associated with poorer prognosis.