1591 CT EVALUATION OF NEONATES WITH SEIZURES ATTRIBUTABLE TO PERINATAL COMPLICATIONS

Abstract

Although the incidence of neonatal seizures has been reported to be 0.2 - 0.8%, seizures are more prevalent in NICUs. During a 36 month interval, 116 (3%) of all our NICU patients had one or more seizures. In 75 (65%) patients, these seizures were attributable to perinatal complications, either intracranial hemorrhage or asphyxia, defined as a 5 min. Apgar score of ≤4, and could be divided by age of occurrence into early seizures ( 24 hrs of age). 56 of these 75 infants, 26 preterm (PT) and 30 full term (FT) survived for greater than 72 hrs. 24/26 PT and 24/30 FT infants were evaluated by CT scan. Of those 24 PT infants, 23 had late seizures at an average age of 55 hrs; 22 had intraventricular hemorrhages (IVH) and l had a subarachnoid hemorrhage (SAH). The other PT infant was asphyxiated and had an early seizure with a normal CT scan. Of the 24 FT infants, 19 had early seizures at a mean age of 9 hrs. 2 of those infants had subdural hematomas, 3 had focal regions of infarction, and the remaining 15 had normal scans, 5 FT infants had late seizures at a mean age of 56 hrs and had SAH. Thus, although echoencephalography has been found to be extremely useful for the diagnosis of IVH in PT infants, FT neonates with both early and late neonatal seizures should be evaluated by CT scan for the detection of intracranial lesions requiring immediate and/or close follow-up care.