Spectrum and immediate outcome of seizures in neonates

To determine the frequency, etiology, the clinical types, and outcome of seizures in neonates during the course of stay in the neonatal unit.

Cross-sectional study.

Pediatric Department, LMCH, from February 2000 to April 2001.

All neonates (1-28 days) presented with seizures during that period were included in the study. Their detailed history, physical examination, and appropriate investigations were recorded on a study proforma.

Out of a total 680 patients, 100 patients presented with the seizures; this comprises the frequency of 14.7%. Male to female ratio was 2.1:1. Regarding gestational age, 65% were full-term, 31% were pre-term, and 4% were post-term. Regarding etiology, 40% patients had birth asphyxia; 14% had hypoglycemia; 12% were due to hypocalcaemia, 5% were due to intracranial hemorrhage (ICH), 4% had malformation, 10 % had infection /neonatal sepsis, and in 12%, the etiology was kernicterus. Among the patients with seizures, 45% were completely recovered and discharged and 15% patients had neurological deficit at the time of discharge. From the hospitalized 100 patients, 22% expired. The critical factors for the outcome were etiology, gestational age, birth weight, APGAR score, and clinical characteristics. Generally, birth asphyxia had poor, while metabolic causes had good prognosis.

Frequency of seizures was higher in full term (65%) neonates than pre-term (31%). Among the etiological factors birth asphyxia was found to be the most common cause, and showed unfavorable outcome in this series. Common risk factors were low birth weight, pre-maturity, home delivery, pregnancy-induced hypertension and premature rupture of membranes.