Seizures etiology in the newborn period

To determine the causes of seizures in the newborn period.

Cross-sectional analytical study.

Neonatal Unit, Paediatric Department, Allied Hospital, Faisalabad, from April 2003 to June 2004.

A total of 200 neonates of either gender who presented with seizures or developed seizures during hospital stay were evaluated for the possible etiological factors. Blood glucose, serum calcium, blood counts, cerebrospinal fluid examination and cranial ultrasound were done in all patients while blood culture, serum creatinine, CT scan, metabolic screening and Torch antibody titre were done in selected patients guided by history, examination and initial investigations. Results were analysed using SPSS software and Chi-square test. P-value of less than 0.05 was considered significant.

Birth asphyxia was the commonest cause of seizures in the newborn period present in 35% (n = 70) cases. Other commonly identified causes were septicaemia with or without CNS infections 34% (n = 68), metabolic abnormalities 12.5% (n = 25), and intracranial bleed 9.5% (n = 19) cases. Less common causes were kernicterus 4.5% (n = 9), hydrocephalus 1.5% (n = 3), brain malformations 1% (n = 2) and lignocaine toxicity 1% (n = 2) cases. Seizure with presumed idiopathic etiology i.e. 5th day fit was found in only 1% (n = 2) cases.

Etiology of neonatal seizures was identified in 99% cases. It is concluded that neonatal seizures are rarely idiopathic, therefore, an extensive diagnostic work up is needed to establish the cause of seizures in the newborn period.