Hyperglycemia linked to increased seizure risk in neonatal encephalopathy

Specialists have reported a strong association between hyperglycemia and EEG-confirmed seizure clusters in infants with hypoxic-ischemic encephalopathy (HIE) treated with therapeutic hypothermia.

Presenting at the ICNA/CNS 2020 virtual conference, Dr Carlos Ivan Salazar from the Hospital for Sick Children in Toronto, Canada, noted that seizures occur in almost one-third of infants with HIE treated with hypothermia.

Both hypoglycemia and hyperglycemia are common in infants with HIE, and have been associated in previous research with worse neurodevelopmental outcomes, although relatively little is known about their temporal relationship with neonatal seizures.

To investigate, Dr Salazar and colleagues performed a prospective cohort study of 46 newborns (postmenstrual age 36 weeks or more) with HIE treated with therapeutic hypothermia. This involved continuous glucose monitoring, and amplitude-integrated EEG/continuous EEG monitoring for the first 3 days after birth.