Neonatal Seizures: Frequency, Clinical Forms, Aetiology and Outcome in Tropical Practice

Abstract

Background: Seizures are common cause of paediatric admissions in poor resource countries and a risk factor for neurodevelopmental impairment. This study aimed to determine the frequency, clinical forms, aetiology and outcome of seizures in relation to rectal temperature in newborn. Patients and Methods: The study was located in paediatric department of our University Hospital. This prospective research had assessed consecutive admitted newborns aged 0-28 days with incident seizure during a period from January to December, 2013. Newborns with epilepsy and non-incident admission seizure were excluded. Results: Seizures were observed in 344/4836 (7.1%). The sample included 192 males and 152 females. The seizures frequency in newborn 0-21 days was 95.9% and was 52.6% in neonates < 1day. The focal seizures were reported in 68% follow by generalized tonic-clonic in 24.4%. Status epilepticus was observed in 7.6%. Seizures had occurred in a context of hypothermia in 77.9%, normal temperature, 14.2% and hyperthermia in 7.8%. The hypothermia and normal temperature seizures were more common in newborn < one week and hyperthermia was noted in older. The associated pathologies in the context of hyperthermia were neonatal infections (17.4%) and falciparum malaria (22.7%) respectively in one week newborn and older. Perinatal ischaemic/hypoxic (35.5%), falciparum malaria (13.6%) and respiratory tract infections and gastroenteritis (11.8%) were the main diseases associated with seizures in the context of hypothermia and normal temperature. The aetiologies were marked by neonatal brain injuries and perinatal asphyxia. Sixteen neonates with seizures were died giving a direct mortality rate of 4.7%. Eight (2.3%) surviving newborns had heavy neurodevelopmental deficits at discharge. Conclusion: The neonate seizures are an indicative of infection with or without fever. The causes of newborn convulsions must be prevented through a wide available public health programs.