{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:40:28Z","timestamp":1786977628609,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T00:00:00Z","timestamp":1756512000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Neonatal seizures initiate the onset of epilepsy in less than 20% of cases. Establishing accurate and prompt diagnosis for precision medicine, offering tailored care, and informing families about neurodevelopmental prognosis represents a significant challenge. We aim to describe the natural history of drug\u2010resistant epilepsy and negative brain MRI with neonatal onset, and to identify predictors of neurodevelopmental outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed demographic, clinical, electroencephalogram (EEG), and genetic data from neonates with epilepsy onset before 1 month of age, with no provoked cause, and a normal brain MRI, followed at a tertiary center from 2000 to 2020. Neonates with self\u2010limited epilepsy (SLE) or those responding to phenobarbital without later epilepsy were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 56 patients, 60% had a genetic etiology (KCNQ2, STXBP1, KCNT1, others). Most (96%) developed intellectual disability (ID); moderate ID without cerebral palsy (CP) was recorded in 11, and profound intellectual and multiple disabilities (PIMD) in 42. Only two patients had a favorable neurodevelopmental outcome without intellectual disability. An abnormal neurological exam at epilepsy onset was the sole risk factor for future PIMD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Neonatal\u2010onset pharmacoresistant epilepsies with a normal brain MRI are predominantly monogenic and lead to poor neurodevelopmental outcomes. An abnormal initial neurodevelopmental assessment predicts future PIMD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain Language Summary<\/jats:title>\n                    <jats:p>Our study found that epilepsy starting in the neonatal period is often linked to a strong genetic component. The prognosis is generally poor, with frequent neurodevelopmental delays. An abnormal neurological examination during the neonatal period is a predictor of worse outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi4.70126","type":"journal-article","created":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T14:25:38Z","timestamp":1756563938000},"page":"1605-1616","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Long\u2010term outcomes of a cohort of patients with pharmacoresistant neonatal epilepsy and negative brain\n                    <scp>MRI<\/scp>"],"prefix":"10.1002","volume":"10","author":[{"given":"Thibault","family":"Beretti","sequence":"first","affiliation":[{"name":"Pediatric Neurology Department La Timone Children Hospital, APHM  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Rozalen","sequence":"additional","affiliation":[{"name":"Neonatology Department La Conception Hospital, APHM  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Villard","sequence":"additional","affiliation":[{"name":"Medical Genetics Department La Timone Children Hospital, APHM  Marseille France"},{"name":"Aix\u2010Marseille University, MMG, Inserm  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Riccardi","sequence":"additional","affiliation":[{"name":"Aix\u2010Marseille University, MMG, Inserm  Marseille France"},{"name":"Medical Genetics Department Sainte Musse Hospital, CHITS  Toulon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geraldine","family":"Daquin","sequence":"additional","affiliation":[{"name":"Clinical Neurophysiology La Timone Children Hospital, APHM  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Lepine","sequence":"additional","affiliation":[{"name":"Pediatric Neurology Department La Timone Children 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