Clinico-etiological profile of seizures in term and near-term neonates: tertiary care hospital based observational study

Abstract

Background: Neonatal period is very important for development of immature brain and it is also most vulnerable period for development of seizures. Seizures have varied etiology as well as presentation during neonatal period. Considering this we planned this study with objective of finding incidence, etiology, type and time of onset of seizures and their correlation along with short term outcome.Methods: It is a prospective observational study done in level 2 NICU set up of Government Medical College from November 2008 to September 2009. Total 115 term and near term neonates (≥35 weeks of gestation) presenting in NICU with seizures were enrolled in study. All relevant details were recorded on performa and investigations were sent. Data was described as mean±SD and %. SPSS 13 software was used as data analysis.Results: Incidence of seizures came out to be 6.1% of total NICU admission, which was more in male appropriate for gestational age (AGA) babies and those who were born vaginally, extramural and to primiparous mother. Birth asphyxia was most common etiology of seizures and majority presented within 24 hours of birth and meningitis was most important cause of seizure after 7 days of life. Subtle seizures were most common clinical type of seizure in the present study. Risk factor for poor neurological outcome came out to be Hypoxic Ischemic Encephalopathy (HIE). Conclusions: Hypoxic ischemic encephalopathy was most important etiology of neonatal seizures and most important risk factor for poor neurological outcome and subtle seizures being most common clinical type of seizure.