Courtney J. Wusthoff
Stanford University
Internal medicineEtiologyPsychologyNeurointensive careNeurologyIntensive care medicinePediatricsProspective cohort studyCohort studyStatus epilepticusHypothermiaNeonatal encephalopathyEpilepsyEncephalopathyMEDLINENeonatal seizureEeg monitoringHypoxic Ischemic EncephalopathySymptomatic seizuresAnesthesiaElectroencephalographyMedicine
Publications 93
#2Janette Mailo (Glenrose Rehabilitation Hospital)
Last. Taeun Chang (GW: George Washington University)H-Index: 30
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Neonatal encephalopathy (NE) is the most common etiology of acute neonatal seizures - about half of neonates treated with therapeutic hypothermia for NE have EEG-confirmed seizures. These seizures are best identified with continuous EEG monitoring, as clinical diagnosis leads to under-diagnosis of subclinical seizures and over-treatment of events that are not seizures. High seizure burden, especially status epilepticus, is thought to augment brain injury. Treatment, therefore, is aimed at minimi...
1 CitationsSource
#1A.G. Sandoval Karamian (Children's Hospital of Philadelphia)
#2S. Mercimek-Andrews (U of A: University of Alberta)
Last. Courtney J. Wusthoff (Stanford University)H-Index: 28
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Neonatal encephalopathy (NE) describes the clinical syndrome of a newborn with abnormal brain function that may result from a variety of etiologies. HIE should be distinguished from neonatal encephalopathy due to other causes using data gathered from the history, physical and neurological exam, and further investigations. Identifying the underlying cause of encephalopathy has important treatment implications. This review outlines conditions that cause NE and may be mistaken for HIE, along with t...
#1Monica E. Lemmon (Duke University)H-Index: 14
#2Hannah C. Glass (UCSF: University of California, San Francisco)H-Index: 37
Last. Taeun Chang (GW: George Washington University)H-Index: 30
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Abstract null null Purpose null Parents of neonates with seizures are at risk of mental health symptoms due to the impact of illness on family life, prognostic uncertainty, and the emotional toll of hospitalization. A family-centered approach is the preferred model to mitigate these challenges. We aimed to identify strategies to promote family-centered care through an analysis of parent-offered advice to clinicians caring for neonates with seizures. null null null Basic procedures null This pros...
#1Rebecca J. Levy (Lucile Packard Children's Hospital)H-Index: 6
#2Elizabeth W. Mayne (Lucile Packard Children's Hospital)H-Index: 1
Last. Courtney J. Wusthoff (Lucile Packard Children's Hospital)H-Index: 28
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BACKGROUND Guidelines recommend evaluation for electrographic seizures in neonates and children at risk, including after cardiopulmonary bypass (CPB). Although initial research using screening electroencephalograms (EEGs) in infants after CPB found a 21% seizure incidence, more recent work reports seizure incidences ranging 3-12%. Deep hypothermic cardiac arrest was associated with increased seizure risk in prior reports but is uncommon at our institution and less widely used in contemporary pra...
1 CitationsSource
#1Zachary M. Grinspan (Cornell University)H-Index: 16
#2Kelly G. Knupp (Anschutz Medical Campus)H-Index: 19
Last. John R. Mytinger (Nationwide Children's Hospital)H-Index: 11
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Objective. null Compare the effectiveness of initial treatment for infantile spasms. null Methods. null The National Infantile Spasms Consortium prospectively followed children with new onset infantile spasms that began at age 2-24 months at 23 US centers (2012-2018). Freedom from treatment failure at 60 days required no second treatment for infantile spasms and no clinical spasms after 30 days of treatment initiation. We managed treatment selection bias with propensity score weighting and withi...
#1Renée A. Shellhaas (UM: University of Michigan)H-Index: 32
#2Courtney J. Wusthoff (Stanford University)H-Index: 28
Last. Cameron Thomas (UC: University of Cincinnati)H-Index: 8
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OBJECTIVE We aimed to evaluate early-life epilepsy incidence, seizure types, severity, risk factors, and treatments among survivors of acute neonatal seizures. METHODS Neonates with acute symptomatic seizures born 7/2015-3/2018 were prospectively enrolled at nine Neonatal Seizure Registry sites. One-hour EEG was recorded at age three months. Post-neonatal epilepsy and functional development (Warner Initial Developmental Evaluation of Adaptive and Functional Skills - WIDEA-FS) were assessed. Cox ...
#1Hannah C. Glass (UCSF: University of California, San Francisco)H-Index: 37
#2Janet S. Soul (Boston Children's Hospital)H-Index: 37
Last. Renée A. Shellhaas (UM: University of Michigan)H-Index: 32
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Importance Antiseizure medication (ASM) treatment duration for acute symptomatic neonatal seizures is variable. A randomized clinical trial of phenobarbital compared with placebo after resolution of acute symptomatic seizures closed early owing to low enrollment. Objective To assess whether ASM discontinuation after resolution of acute symptomatic neonatal seizures and before hospital discharge is associated with functional neurodevelopment or risk of epilepsy at age 24 months. Design, Setting, ...
4 CitationsSource
#1Monica E. Lemmon (Duke University)H-Index: 14
#2Courtney J. Wusthoff (Stanford University)H-Index: 28
Last. Lisa Anne Rasmussen (UVM: University of Vermont)
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Engaging with ethical issues is central to the management of neonatal encephalopathy (NE). As treatment for these neonates evolves, new ethical issues will arise and many existing challenges will remain. We highlight three key ethical issues that arise in the care of neonates with NE treated with therapeutic hypothermia: facilitating shared decision making, understanding futility, and defining the boundaries between standard of care and research. Awareness of these issues will help clinicians co...
#1Courtney J. Wusthoff (Stanford University)H-Index: 28
#2Vandana Sundaram (Stanford University)H-Index: 25
Last. Renée A. Shellhaas (UM: University of Michigan)H-Index: 32
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OBJECTIVE To determine whether screening continuous EEG monitoring (cEEG) is associated with greater odds of treatment success for neonatal seizures. METHODS We included term neonates with acute symptomatic seizures enrolled in the Neonatal Seizure Registry (NSR), a prospective, multicenter cohort of neonates with seizures. We compared two cEEG approaches: (1) Screening cEEG, initiated for indications of encephalopathy or paralysis without suspected clinical seizures, and (2) Confirmatory cEEG, ...