Neonatal seizures in Nigerian infants

Area of Science:

• Neonatal Medicine
• Pediatric Neurology
• Public Health

Background:

• Neonatal seizures represent a significant clinical challenge in newborns.
• Identifying the etiology of seizures is crucial for appropriate management and prognosis.
• Previous studies in Nigeria have highlighted various causes, but patterns can vary geographically and over time.

Purpose of the Study:

• To prospectively determine the causes and seizure patterns in Nigerian newborns presenting with convulsions.
• To analyze the frequency of different etiological factors, including infections and metabolic disturbances.
• To assess the mortality rate and its correlation with underlying causes and prematurity.

Main Methods:

• Prospective study of 60 newborns with convulsions admitted to the University of Calabar Teaching Hospital between January 1989 and December 1990.
• Data collection focused on identifying etiological factors (birth asphyxia, infections, hypoglycemia, etc.) and seizure types.
• Analysis of infection types (meningitis, septicemia) and causative organisms (coliforms, Staphylococcus aureus).

Main Results:

• Neonatal seizures occurred in 4% of Newborn Unit admissions.
• Birth asphyxia, infections, and hypoglycemia were the primary causes, acting either singly or in combination in 96% of cases.
• Generalized seizures were prevalent (63%), likely due to mixed etiologies. Mortality rate was high at 50%, linked to etiology and prematurity.

Conclusions:

• Identifiable causes of neonatal seizures in this Nigerian setting are potentially preventable through enhanced obstetric and neonatal care.
• There is a critical need for modern diagnostic facilities to improve the investigation and management of newborn seizures.
• The high mortality rate underscores the severity of neonatal seizures and the importance of timely and accurate diagnosis.