Background: Cerebral palsy is the most frequent motor disability in childhood and is associated with a higher incidence of seizure disorders. In many instances, it is recognized that motor difficulties, as well as seizures, are from the same underlying brain lesion. However, self-limited childhood epilepsies, being a common group of epilepsy syndromes, would be expected to occur in patients with cerebral palsy merely on chance association and be unrelated to the structural brain imaging abnormality causing the motor impairment. Differential diagnosis in this case is important determining the long-term prognosis and need for anticonvulsant treatment. Case Presentation: Here, we report two patients with cerebral palsy combined with epilepsy, whose age at onset, seizure semiology and electroclinical features were similar to children with self-limited childhood-specific seizure disorders (childhood epilepsy with centrotemporal spikes and Panayiotopoulos syndrome). Conclusion: These cases highlight the importance of comprehensive differential diagnosis of seizures in cerebral palsy. Co-existence of age-dependent focal epilepsies with an underlying brain pathology as white matter injury, not affecting the cerebral cortex, might take place in the case of children with impaired motor skills. With health systems increasingly utilizing clinical pathways, it is important to consider the possibility of a self-limited childhood epilepsy and avoid aggressive and unnecessary medication treatment in children with cerebral palsy.

Aim: This study is aimed at evaluating the cumulative effect of postnatal risk factors on the survival of preterm neonates by examining key clinical parameters and complications across various gestational ages. Methods: A retrospective cohort study was conducted using data from 1109 neonates admitted to neonatal intensive care units at two tertiary regional hospitals in Kazakhstan between 2021 and 2024. Patients were classified into three groups based on gestational age: extremely preterm (< 28 weeks, n = 223), very preterm (28–31 weeks, n = 384), and moderate to late preterm (32–36 weeks, n = 502). Initially, to identify significant risk factors, categorical variables were analyzed using the χ ² test or Fisher’s exact test with the Bonferroni correction, depending on whether the expected counts were ≥ 5 or < 5, while continuous variables were examined with the Kruskal–Wallis and Mann–Whitney U tests. Subsequently, multivariate logistic regression was applied to develop a prognostic model for each study group based on previously identified statistically significant risk factors for neonatal mortality. The predictive performance of these factors was further evaluated through ROC curve analysis with AUC. Finally, the Kaplan‐Meier method was used to reflect overall mortality outcomes, illustrating their association with gestational age and the distribution of fatal cases over time in days. Results: The results of this study reveal significant differences in survival rates among preterm neonates based on gestational age, with mortality being most pronounced in infants born at less than 28 weeks of gestation. As gestational age increased among preterm infants, there was a marked reduction in the number of statistically significant independent risk factors identified in logistic models that influence survival. Disseminated intravascular coagulation consistently emerged as a significant predictor across all three logistic models. Neonatal depression, hyperbilirubinemia, and necrotizing enterocolitis were significant in both extremely preterm infants (less than 28 weeks) and very preterm infants (28–31 weeks). However, patent ductus arteriosus and bronchopulmonary dysplasia were statistically significant only in the extremely preterm group (less than 28 weeks). Conclusion: In a cohort of preterm neonates in Kazakhstan, the cumulative impact of various risk factors plays a critical role in determining survival outcomes, with increasing gestational age significantly enhancing the likelihood of survival. Further research is required to refine prognostic models and identify factors specific to different sociogeographical populations.

Objective: To estimate anti-seizure medication (ASM) treatment burden and its effects on health-related quality of life (HRQOL) in new-onset childhood epilepsy with centrotemporal spikes (CECTS) using different treatment approaches in Kazakhstan. Methods: Forty-three patients were followed prospectively during 2015 to 2020 for at least 2 years. Patients were divided into three groups: (1) history of ≤3 seizures (n = 32); (2) ≥4 seizures (n = 6); (3) cerebral palsy coexisting with CECTS (n = 5). The first group was subdivided into treated (n = 8) and observed (n = 24) subgroups. The shortened Quality of Life in Childhood Epilepsy Questionnaire (QOLCE-55) was completed by parents after 6 months of follow-up. Results: At the end of the study, all children had a sustained remission from seizures for at least 2 years. Differences were identified in emotional, social, and physical subscales between patients in the low seizure frequency group. Signs of low self-esteem, anxiety, depression, limited social interaction owing to pharmacotherapy, painful medical procedures, and stigma were reasons for decreased HRQOL in the treated subgroup. Overall HRQOL in treated (89.2 ± 5.2) patients was significantly decreased compared with observed children with low seizure frequency (98.0 ± 3.0). Conclusion: ASM therapy does not necessarily improve and may decrease HRQOL in children with low seizure frequency CECTS.

Background: An estimated 13.4 million infants were born preterm worldwide in 2020, highlighting the need for early identification of those at risk of adverse neonatal outcomes. Preterm infants constitute a heterogeneous population in terms of maturity and clinical risk. A simple model based on variables available immediately after birth may facilitate the early identification of infants who require more intensive monitoring. Objective: This study aimed to develop and internally validate an early prediction model for a composite adverse neonatal outcome in preterm infants. Materials and Methods: This single-center prospective cohort study included 280 preterm infants born at 24 weeks to 36 weeks and 6 days of gestation. The primary endpoint was the occurrence, before hospital discharge, of at least one of the following events: death, grade III-IV intraventricular hemorrhage (IVH), grade III–IV periventricular leukomalacia (PVL), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), or culture-confirmed early- or late-onset neonatal sepsis. A binary logistic regression model was developed. Discrimination was assessed using the area under the receiver operating characteristic curve (AUC ROC). Calibration was assessed graphically and by the Brier score, calibration intercept, and calibration slope. Internal validation was performed using 10-fold cross-validation and bootstrap optimism correction with model refitting in each of 2000 bootstrap samples. Results: The composite outcome occurred in 35 of 280 infants (12.5%). The final model included gestational age (odds ratio [OR] 0.736 per additional week; 95% confidence interval [CI] 0.614–0.882; p < 0.001) and the 5 min Apgar score (OR 0.447 per additional point; 95% CI 0.286–0.701; p < 0.001). The apparent AUC was 0.904 (95% bootstrap CI 0.848–0.952), the optimism-corrected AUC was 0.898, and the out-of-fold AUC from 10-fold cross-validation was 0.892. The out-of-fold Brier score was 0.066; the calibration intercept was −0.113, and the calibration slope was 0.925. The probability cutoff of 0.142 and the corresponding classification measures were considered exploratory. Conclusions: A two-variable model based on gestational age and the 5 min Apgar score demonstrated high internal discriminative ability. The model is intended for research evaluation and early risk stratification; independent external validation is required before clinical implementation.

Background: Early identification of brain dysfunction in preterm infants remains challenging because cranial ultrasonography (CUS) may not capture early neurophysiological abnormalities. Serum S100B has been proposed as a marker of neonatal brain injury, but its relationship with electroencephalographic (EEG) abnormalities in preterm infants remains unclear. Objectives: Our objectives were to evaluate the association between early neonatal serum S100B concentrations and EEG abnormality severity in preterm infants and to determine whether similar associations are observed with structural brain injury detected by CUS. Methods: This prospective observational cohort included 116 preterm infants from 281 prospectively enrolled neonates. Serum S100B was measured within the first 24 h of life. Conventional multichannel EEG was performed at 10–14 days of life, and CUS was performed serially to assess intraventricular hemorrhage (IVH) and periventricular leukomalacia (PVL). Associations with EEG severity were evaluated using correlation analysis and ordinal logistic regression. A sensitivity analysis was restricted to infants with a postmenstrual age (PMA) ≤ 36 weeks at EEG and used a preterm-specific EEG grading system. Results: Higher log10(S100B) concentrations were associated with greater EEG abnormality severity (Spearman’s ρ = 0.49, p < 0.001) and remained independently associated after adjustment for gestational age and Respiratory Distress Syndrome (RDS) (adjusted OR 19.95, 95% CI 4.97–80.16; p < 0.001). No significant associations were observed between S100B concentrations and IVH or PVL severity. In the PMA-restricted sensitivity analysis (n = 89), the association between S100B and EEG abnormality severity remained significant using the preterm-specific grading system (ρ = 0.54, p < 0.001). Conclusions: During the early neonatal period, higher serum S100B concentrations were associated with greater neurophysiological abnormality severity in preterm infants, whereas associations with ultrasound-defined IVH or PVL were not demonstrated. The persistence of the S100B–EEG association in the PMA-specific sensitivity analysis supports the robustness of this finding across EEG grading approaches.