J Thorac Cardiovasc Surg 2006;132:441
© 2006 The American Association for Thoracic Surgery
Electrographic seizure after neonatal and infant cardiac surgery
Syed Faisal Hashmi, MBBS
a
,
Muhammad Hanif, MRCS
a
,
Kathleen O'Reilly, MRCPCH
b
a Department of Paediatric Cardiothoracic Surgery, Royal Hospital for Sick Children, Glasgow, United Kingdom
b Department of Paediatric Cardiology, Royal Hospital for Sick Children, Glasgow, United Kingdom
To the Editor:
We read with interest the article by Gaynor and associates,
1
titled "Relationship of Postoperative Electrographic Seizure to Neurodevelopmental Outcome at 1 Year of Age After Neonatal and Infant Cardiac Surgery." We appreciate the effort and hard work of the authors on this complex neurophysiologic phenomenon.
In this study postoperative electroencephalographic (EEG) seizures have been identified in a small number of patients (15/144, 13%), with absolutely no seizure activity reported in patients with transposition of the great arteries and ventricular septal defect. The latter are considered among the high-risk groups.
2,3
This observation may be quite startling or may be purely coincidental.
The authors did not mention the preoperative seizure history or duration of seizure activity
4
(which can significantly contribute to seizure-related neuronal death), and they did not discuss whether the EEG examiners were blinded to the fact that the child had a seizure in the postoperative period.
Gaynor and associates rightly mentioned that antiepileptic medication given to all the patients was not standardized and there was no control group, so it is not possible to determine conclusively whether treatment affected the neurodevelopmental outcome.
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References
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- Gaynor JW, Jarvik GP, Bernbaum J, Gerdes M, Wernovsky G, Burnham NB, et al. The relationship of postoperative electrographic seizures to neurodevelopment outcome at 1 year of age after neonatal and infant cardiac surgery. J Thorac Cardiovasc Surg 2006;131:181-189.[Abstract/Free Full Text]
- Helmers SL, Wypij D, Contantinou JE. Perioperative EEG seizures in infants undergoing repair of complex congenital cardiac defects. Electroencephalogr Clin Neurophysiol 1997;102:27-36.[Medline]
- Hovels-Gurich HH, Seghaye MC, Sigler M. Neurodevelopmental outcome related to cerebral risk factor in children after neonatal arterial switch operation. Ann Thorac Surg 2001;71:881-888.[Abstract/Free Full Text]
- Fujikawa DG. Prolonged seizures and cellular injury. understanding the connection. Epilepsy Behav 2005;7(suppl 3):S3-S11Epub 2005 Nov 8.
Related Article
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Reply to the Editor
- J. William Gaynor, Gil Wernovsky, and Robert R. Clancy
J. Thorac. Cardiovasc. Surg. 2006 132: 441-442.
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