Utility of Rapid Sequence Magnetic Resonance Imaging in Guiding Management of Patients With Neonatal Seizures

Theresa Czech; Andrea C Pardo

doi:10.1016/j.pediatrneurol.2019.08.001

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Utility of Rapid Sequence Magnetic Resonance Imaging in Guiding Management of Patients With Neonatal Seizures

Journal article

Peer reviewed

Utility of Rapid Sequence Magnetic Resonance Imaging in Guiding Management of Patients With Neonatal Seizures

Theresa Czech and Andrea C Pardo

Pediatric neurology, Vol.103, pp.57-60

02/2020

DOI: 10.1016/j.pediatrneurol.2019.08.001

PMID: 31570293

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Abstract

To determine whether the use of rapid sequence magnetic resonance imaging (rsMRI) is associated with improved efficiency of care when managing infants with suspected neonatal onset seizures. We conducted a preintervention and postintervention study of the use of rsMRI in term infants with suspected neonatal onset seizures without evidence of hypoxic ischemic encephalopathy. Study patients were collected from a contemporary cohort from 2016 to 2017 and were compared with a historical cohort from 2014. The primary outcome was hospital length of stay. Secondary outcomes included use of other imaging modalities (head ultrasound, computed tomography [CT], and MRI), use of antiseizure medications at the time of discharge, and cost of hospitalization. Continuous variables were compared using the Mann-Whitney U test and categorical variables using the Fisher's exact or χ tests. A two-tailed P < 0.05 was considered statistically significant. Ninety-five patients met inclusion criteria, 47 in the preintervention and 48 in the postintervention group. Incorporation of the protocol-guided rsMRI in the evaluation of patients with neonatal seizures was associated with decreased use of CT scans (34% vs 10%, P = 0.007) and full MRIs (85% vs 62%, P = 0.019). Use of head ultrasound, length of stay, and costs were not different between groups. In patients with neonatal seizures, rsMRI was not associated with a reduced hospital length of stay. The use of rsMRI resulted in fewer neonates receiving CT scans during their hospitalization. rsMRI may hasten the identification of stroke or hemorrhage in neonates with seizures.

Brain Diseases - complications

Brain Diseases - diagnostic imaging

Brain Diseases - therapy

Clinical Protocols

Female

Humans

Infant, Newborn

Intensive Care Units, Neonatal

Intensive Care, Neonatal - methods

Intensive Care, Neonatal - standards

Length of Stay - statistics & numerical data

Magnetic Resonance Imaging - methods

Magnetic Resonance Imaging - standards

Magnetic Resonance Imaging - statistics & numerical data

Male

Retrospective Studies

Seizures - diagnostic imaging

Seizures - etiology

Seizures - therapy

Tomography, X-Ray Computed - statistics & numerical data

Details

Title: Subtitle: Utility of Rapid Sequence Magnetic Resonance Imaging in Guiding Management of Patients With Neonatal Seizures
Creators: Theresa Czech - Lurie Children's Hospital
Andrea C Pardo - Northwestern University
Resource Type: Journal article
Publication Details: Pediatric neurology, Vol.103, pp.57-60
DOI: 10.1016/j.pediatrneurol.2019.08.001
PMID: 31570293
ISSN: 0887-8994
eISSN: 1873-5150
Language: English
Date published: 02/2020
Academic Unit: Stead Family Department of Pediatrics; Neurology (Pediatrics)
Record Identifier: 9984695679502771

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