TO STUDY CLINICAL PRESENTATION AND TIME OF ONSET OF SEIZURE IN TERM AND PRETERM NEONATES AND THE BIOCHEMICALABNORMALITY IN SEIZURES IN TERM AND PRETERM NEONATES.

Abstract

INTRODUCTION: Seizure is dened as paroxysmal involuntary disturbance of brain function. It may manifest as impairment or loss of consciousness, abnormal motor activity, behavioural abnormality, sensory disturbance or autonomic dysfunction. Any abnormal, repetitive and stereotypic behaviour in neonates should be evaluated as possible seizure. Neonatal seizures is a common neurological problem with a frequency range from 0.95 to 3.5/1000 live births. AIMS & OBJECTIVES:To assess the importance of biochemical abnormalities in neonatal seizures and to evaluate clinical presentation & time of onset of seizures in term and preterm neonates. MATERIAL & METHODS: A total of 90 neonates presenting with seizures admitted to NICU of National Institute of Medical Sciences & Research, Jaipur from conducted from 1st January 2019 till 30 th June 2020 were enrolled in the study. Detailed antenatal, natal, postnatal history along with detailed examination was done. Baseline characteristics of convulsing neonate including sex, gestational age, birth weight, head circumference & length were recorded at admission. Clinical details of each seizure episode reported by the mother and subsequently observed by the resident doctors on duty were recorded i.e. age at onset of seizures, duration of seizure, number and type of seizure. Relevant investigations including biochemical parameters were done immediately after baby had seizures and before instituting any specic treatment. Etiology of neonatal seizures and associated biochemical abnormalities were diagnosed. RESULTS: In the present study, out of 90 neonates studied, 64 were full term of which 49(76.5%) were AGAand 15(23.5%) were SGA, whereas 26 cases were preterm. The male: female ratio is 1.3:1. Most neonatal seizures occur in rst 3 days of life, i.e. 60 %. Most of them occurred on rst day of life (34%). Birth asphyxia was the cause of neonatal seizures in 82 % neonates who developed seizures on day-1 of life. Birth asphyxia and septicemia are common cause of neonatal seizures in our study, followed by pure metabolic disturbances 20 %. In pure metabolic seizures, hypoglycemia (47.8%) is most common more in preterm babies (55%) followed by hypocalcemia. In cases of non- metabolic seizures, which showed associated biochemical abnormalities, hypoglycemia was most common abnormality 24 of 52 cases (46.15%). 12 cases (52.1%) are associated with birth asphyxia and 11 cases (47.9%) are associated with septicemia. CONCLUSION: Biochemical abnormalities are common in neonatal seizures and often go unrecognized. These abnormalities may signicantly contribute to seizure activity correction of these abnormalities may play a signicant role in seizure control. Hence, a biochemical work up is necessary for all cases of neonatal seizures.