DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20194717

Clinico-epidemiological study of neonatal seizures from a tertiary care hospital of Western Rajasthan, India

Suresh Kumar Verma, Jagdish Chand Dabi, Sandeep Rawat, Basanti Dabi

Abstract


Background: Neonatal Seizures are frequent may be either symptoms of an underlying disorder and malfunction of the developing CNS or due to a primary epileptic condition. Their varied clinical presentations, delay in recognition and treatment results in poor neurological outcome. This study attempts to find out the clinical and etiologic profile of neonatal seizures and associated biochemical abnormalities in this geographical part of India.

Methods: A hospital based prospective observational study undertaken in a tertiary care pediatric hospital of Medical College Jodhpur India, on 202 consecutive neonates who presented with seizures during period of one year. A detailed antenatal history and baseline characteristics of convulsing neonate at admission and clinical details of each seizure episode reported by the mother and subsequently observed by doctors on duty were recorded. Venous blood sample was analyzed as soon as possible for blood glucose, total serum calcium levels and electrolytes, before instituting any treatment. Data were managed on Microsoft Excel spreadsheet, and analysis was performed using SPSS version.

Results: The overall frequency of neonatal seizures in our set up was recorded as 4.08%. Perinatal asphyxia with subsequent HIE was the most common (40.09%) cause of neonatal seizures while hypoglycemia was the most common metabolic cause (11.38%) observed specially in VLBW babies. Subtle seizures were the most common type (34.65%) and tonic seizures were the second most common (33.66%) type of seizures encountered. Hypocalcemia was the second commonest biochemical abnormality found in primary metabolic seizures. HIE, ICH and Hypoglycemia were the common seizure etiology in preterm neonates.

Conclusions: Perinatal asphyxia and subsequent HIE was the commonest etiology with subtle, tonic and multifocal seizures being the commonest clinical types encountered. Hypoglycemia and hypocalcemia were the most frequent biochemical abnormality found.


Keywords


Hypoglycemia, Hypocalcaemia, Hypoxic ischemic encephalopathy, Non-metabolic seizures, Primary metabolic seizures

Full Text:

PDF

References


Eric C Eichenwald; Anne R Hansen; Camilia Martin; Ann R Stark. Manual of neonatal care. -Cloherty JP. 7th ed. Philadelphia:Wolters Kluwer; 2011: 729-742.

Volpe JJ. Neonatal seizures. Neurology of the new-born. Philadelphia, PA: WB Saunders, 2001: 178-214.

Airede KI. Neonatal seizures and a 2-year neurological outcome. J Trop Pediatr. 1991 Dec 1;37(6):313-7.

Nuñez JL, Alt JJ, McCarthy MM. A novel model for prenatal brain damage: II. Long-term deficits in hippocampal cell number and hippocampal-dependent behavior following neonatal GABAA receptor activation. Exper Neurol. 2003 Jun 1;181(2):270-80.

Sarnat HB, Sarnat MS. Neonatal encephalopathy following fetal distress: a clinical and electroencephalographic study. Arch Neurol. 1976 Oct 1;33(10):696-705.

Mercuri E, Cowan F, Rutherford M, Acolet D, Pennock J, Dubowitz L. Ischaemic and haemorrhagic brain lesions in newborns with seizures and normal Apgar scores. Arch Dis Child Fetal Neonat Edit. 1995 Sep 1;73(2):F67-74.

Scher MS, Belfar H, Martin J, Painter MJ. Destructive brain lesions of presumed fetal onset: antepartum causes of cerebral palsy. Pediatr. 1991 Nov 1;88(5):898-906.

Scher MS, Hamid MY, Steppe DA, Beggarly ME, Painter MJ. Ictal and interictal electrographic seizure durations in preterm and term neonates. Epilepsia. 1993 Mar;34(2):284-8.

Sheth RD, Hobbs GR, Mullett M. Neonatal seizures: Incidence onset and etiology by gestational age. J Perinatol. 1999;19:40-3.

Kairam R, De Vivo DC. Neurologic manifestations of congenital infection. Clin Perinatol. 1981; 8:455-65.

Brown JK, Cockburn F, Forfar JO. Clinical and chemical correlates in convulsions of the newborn. Lancet. 1972 Jan 15;299(7742):135-8.

Sood A, Grover N, Sharma R. Biochemical abnormalities in neonatal seizures. Indian J Pediatr. 2003 Mar 1;70(3):221-4.

Keen JH, Lee D. Sequelae of neonatal convulsions. Study of 112 infants. Arch Dis Child. 1973 Jul;48(7):542.

Rose AL, Lombroso CT. A study of clinical, pathological, and electroencephalographic features in 137 full-term babies with a long-term follow-up. Pediatr. 1970 Mar;45(3):404-25.

Scher MS. Avery’s Disease of New-born 8thed. Elsevier Health Sciences; Chapter 66, Neonatal seizures; 2005:1020.

Carole Kenner, Judy, Wright Lott. Comprehensive neonatal care; 4th Ed. Chapter 8, Elsevier Health Sciences; 2007:95.

Kumar A, Gupta V, Singla: Biochemical abnormalities in neonatal seizures. Indian Paed. 1995;32(4):424-8.

Ment LR, Freedman RM. Neonates with seizures attributed to perinatal complications. Am J Dis Child. 1982;136:548-50.

Asindi AA, Antia-Obong OE, Ibia EO, Udo JJ. Neonatal seizures in Nigerian infants. Afr J Medi Med Scie. 1995 Sep;24(3):243-8.

Taksande AM, Krishna V, Manish Jain, Mahaveer L. Clinico-biochemical profile of neonatal seizures. Paed Oncall J. 2005 October;2(10):68.

Coen RW, Mc Cutchen CB, Wermer D, Snyder J, Gluck FE. Continuous monitoring of EEG following perinatal asphyxia. J Pediatr. 1982;100:628-30.

Holden KR, Mellitis ED, Freeman JM. Neonatal seizures: correlation of prenatal and perinatal events with outcome. Pediatr. 1982;70:165-76.

Legido A, Clancy RR. Neurologic outcome after EEG proven neonatal seizures. Paediatr. 1991;88:583-96.

Malik BA, Butt MA, Shamoon M, Tehseen Z, Fatima A, Hashmat N. Seizures etiology in the newborn period. J Col Phys Surg Pak: JCPSP. 2005 Dec;15(12):786-90.

Scher MS. Controversies regarding neonatal seizure recognition. Epileptic disorders. 2002;4(2):139-58.