CLINICO-ETIOLOGICAL PATTERN OF NEONATAL SEIZURES

Abstract

Background: Incidence of seizures is highest during the neonatal period, and it is considered a medical emergency that necessitate proper clinical and etiological assessment. Aim: This study aimed to focus on the etiological, clinical classification of neonatal seizures and proper assessment for appropriate diagnosis. Patients and methods: This prospective study was performed on 50 neonatal patients who developed neonatal seizures either prior or after admission to the NICU of Al-Hussein University Hospital and Sayed Galal University Hospital below the age of 28 days after an informed written consent from parents in the period between December 2018 and September 2019 Results: In this study, neonatal seizures were more common in males 27 (54%) than females 23(46%); their mean birth weight was 2748 grams. 40% of patients of the study were complaining of perinatal asphyxia evidenced by history of prolonged or instrumental labor, 11 babies (22%) with sepsis,6 babies (12%) with hypocalcemia, 6 babies (12%)with intraventricular hemorrhage, 3 babies (6%)with intracranial hemorrhage, 3 babies(6%) with kernicterus, one baby (2%) with metabolic disorder (Non ketotic hyperglycinemia ) . Many types of seizures are represented in our study with different ratios; out of which 18 (36%) had myoclonic seizures, 14(28%) had mixed, 8 (16%) babies had subtle, 4(8%) had clonic and 5(10%) had tonic types), and only 1(2%) baby had multifocal clonic fit. Conclusion: This study confirms that Hypoxic ischemic encephalopathy was most important etiology of neonatal seizures and most important risk factor for poor neurological outcome followed by sepsis, intraventricular hemorrhage, intracranial hemorrhage, kernicterus and metabolic respectively and most important risk factor for poor neurological outcome and myoclonic seizures being most common clinical type of seizure observed.