DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20212313

Clinical and biochemical profile of neonatal seizures admitted in neonatal intensive care unit of a tertiary care hospital

Mohanram V., Arulraj Russelian, Palpandi V.

Abstract


Background: Several factors contribute to seizures among neonates. To avoid complications from under recognition of clinical seizures and the adverse effects of medications administered, the diagnosis and management of neonatal seizures necessitate an interprofessional approach. Present study was done to study the clinical and biochemical profile of neonates with seizures admitted to a tertiary care hospital, Chennai.

Methods: A cross sectional study was conducted where all the neonates from birth to 28 days of life who got admitted in the neonatal intensive care unit (NICU) of a tertiary care hospital-Shri Sathya Sai medical college and research institute were included in the study. Baseline characteristics of all the babies were noted on the prescribed proforma. Thorough physical examination was done and seizures were diagnosed by clinical observation. Clinical details of each seizure episode were recorded like age at onset of seizures, duration of seizure, number and type of seizure.

Results: In the present study, 50 neonates satisfying the inclusion and exclusion criteria were included in the study. The main mode of delivery was normal vaginal delivery (50%) followed by LSCS (40%) and assisted delivery (10%). 54% were male and 46% were female and majority of babies were delivered at term i.e., 72% and 28% were pre term babies. The mean day of onset of seizures in the present study was 3.18±2.09. Based on day of onset of seizures, with in 24 hrs (28%), 24 hrs to 72 hrs (46%), 4th day to 1 week (22%), more than 1 week (4%). Based on type of seizure 64% had subtle type, 26% had tonic type and 10% had clonic type of seizures. In this study, 24% had hypoglycemia, and 10 (20%) had hypocalcemia, 14% in the present study had hyponatremia, and 2 (4%) had hypomagnesemia, 2 (4%) had hypernatremia, 6% had combination of hypocalcemia and hypoglycemia.

Conclusions: Hypocalcemia, hypoglycemia, hyponatremia were the common biochemical abnormalities observed in our study. Subtle seizures were the common type of seizures observed among both pre term and term infants.


Keywords


Neonatal seizures, Intensive care unit, Hypocalcemia

Full Text:

PDF

References


Glass HC. Neonatal seizures: advances in mechanisms and management. Clin Perinatol. 2014;41(1):177-90.

Plouin P, Kaminska A. Neonatal seizures. Handb Clin Neurol. 2013;111:467-476.

Abend NS, Wusthoff CJ. Neonatal seizures and status epilepticus. J Clin Neurophysiol. 2012;29(5):441-8.

Vasudevan C, Levene M. Epidemiology and aetiology of neonatal seizures. Semin Fetal Neonatal Med. 2013;18(4):185-91.

Orivoli S, Facini C, Pisani F. Paroxysmal nonepileptic motor phenomena in newborn. Brain Dev. 2015;37(9):833-9.

Ronen GM, Penney S, Andrews W. The epidemiology of clinical neonatal seizures in Newfoundland: a population-based study. J Pediatr. 1999;134(1):71-5.

Lanska MJ, Lanska DJ, Baumann RJ, Kryscio RJ. A population-based study of neonatal seizures in Fayette County, Kentucky. Neurology. 1995;45(4):724-32.

Jensen FE. Neonatal seizures: an update on mechanisms and management. Clin Perinatol. 2009;36(4):881-900.

Nardone R, Brigo F, Trinka E. Acute Symptomatic Seizures Caused by Electrolyte Disturbances. J Clin Neurol. 2016;12(1):21-33.

Moayedi AR, Zakeri S. Neonatal seizure: Etiology and type. J Child Neurol. 2007;2:23-6.

Lakhra, Pushpa C. Clinico-biochemical profile of neonatal seizures in a rural medical college. National neonatol forum. 2003.

Kumar A, Gupta A, Talukdar B. Clinico-etiological and EEG profile of neonatal seizures. Indian J Pediatr. 2007;74(1):33-7.

Rabindran, Parakh H, Ramesh JK, Reddy P. Phenobarbitone for the Management of Neonatal Seizures - A Single Center Study. Int J Med Res Rev. 2015;3(1):63-71.

Aziz A, Gattoo I, Aziz M, Rasool G. Clinical and etiological profile of neonatal seizures: a tertiary care hospital-based study. Int J Res Med Sci. 2015;3:2198-2203.

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

Brunquell PJ, Glennon CM, DiMario FJ Jr, Lerer T, Eisenfeld L. Prediction of outcome based on clinical seizure type in newborn infants. J Pediatr. 2002;140(6):707-12.

Estan J, Hope P. Unilateral neonatal cerebral infarction in full term infants. Arch Dis Child Fetal Neonatal Ed. 1997;76(2):F88-93.

Goldberg HJ. Neonatal convulsions: a ten years review. Arch Dis Childhood. 1982;57:633-5.

Kliegman RM, Behrman RE, Jenson HB, Stanton BF. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, editors. Nelson Textbook of Pediatrics, 18th ed. Saunders; 2007; 471.