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Category: Volume 08 Issue 02 February 2020
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Title: Study of Clinical and Biochemical Profile in Neonatal Seizure in a tertiary care centre of Jharkhand

Authors: Dilip Kumar, Rajeeva Mishra, Gora Chand, Sweety Kumari

 DOI: https://dx.doi.org/10.18535/jmscr/v8i2.07

Abstract

Background: Neonatal seizures are one of the most common and distinctive clinical manifestations of dysfunction of neurological system. Neonatal seizures represent responses of the immature nervous system to varied insults resulting in considerable neonatal mortality and morbidity including motor and cognitive disabilities in the childhood. Neonatal seizures are more common in preterm compared to term neonates and metabolic abnormalities are common cause of neonatal seizure.

Objectives: Current study aims at to study: 1. the incidence of biochemical abnormalities associated with neonatal seizure & 2. the clinical presentation, time of onset and its relation to the neonatal seizures.

Methods: A prospective hospital based study was conducted for a period of 6 months from May 2017 to November 2017, a total of 80 newborns with seizure were enrolled in the study after taking complete history and appropriate physical examination. Blood sample was collected for detecting metabolic abnormalities before instituting specific therapy.

Results: In my study, neonatal seizure occurred more commonly in term babies especially in appropriate for gestational age babies compared to preterm neonates. There was a male predominance. Most seizures are due to intramural deliveries and occurred within 72 hours of life. Seizures are more common in babies with birth weight ≥2.5 kg and subtle seizure is the most common type. The most common biochemical abnormality noted was hypoglycemia (40%) and hypocalcemia (32%). There were cases reported with combination of hypoglycemia / hypocalcemia and hypocalcemia/hypomagnesemia particularly in preterm but their incidence is low.

Conclusion: The transient metabolic abnormalities are easily treatable when identified early and are associated with good prognosis. Hence biochemical work up should be done in all neonates with seizure and should be included as the first line of investigation in all cases, thereby preventing the further occurrence of seizure and overuse of anticonvulsants. It also improve the prognosis and outcome of the neonate and prevent the long term neurological sequelae associated with it.

Keywords:  Neonatal seizure, hypoglycemia, hypocalcemia.

References

  1. Miller SP, WeissJ, BarnwallA, Ferriero DM, Latal HB, Ferrer RA et al. Seizure associated brain injury in term newborn with perinatal asphyxia. Neurology. 2002;58(4):542-8.
  2. Davis AS, Hintz SR, Van KP, LiL, Das A, Stoll BJ et al. Seizure in extremely low birth weight infants are associated with adverse outcome.JPediatr.2010;157(5):720-5.
  3. Holanda MRR, Melo AN. Comperative clinical study of preterm and full term newborn neonatal seizures. Arq Neuropsiquiatr2006;64:282-8.
  4. Aziz A. Gattoo, M Aziz, G Rasool. Clinical and etiological profile of neonatal seizures: A tertiary care hospital based study Int J Res Med Sci.2015 Sep;3(9):2198-2203.
  5. Park, Weon et al. “Clinical study of neonatal seizure.” Journal of the Korean Child Neurology Society6.1(1998):71-82.
  6. Das, Dinesh and Sanjib Kumar Debbarma. “A study on clinic-Biochemical Profile of Neonatal Seizure.” Journal of Neurology Research6.5-6(2016):95-101.
  7. Nawab T, Lakshmipathy NS. Clinical profile of neonatal seizures with special reference to biochemical abnormalities. Int J ContempPediatr2016;3:183-8.
  8. Sudia, Sanjeev et al. “ Clinicoetiological profile and outcome of neonatal seizures.” International Journal of Contemporary Pediatrics2.4(2017):389-394.
  9. Sood A, Grover N, Sharma R. Biochemical abnormalities in neonatal seizures. Indian Journal of Paed.2003;70(3):221-4.
  10. Kumar A, Gupta V, Kachhawaha JS, Singla PN. Biochemical abnormalities in neonatal seizures. Indian Pediatr.1995;32(4):424-428.
  11. Madhusudan K, Nadavapali Suresh S, Babu TR, Rao JV, Kumar S B. Study of biochemical abnormalities in neonatal seizures with special reference to hyponatremia. Int J Contemp Pediatr 2016;3:730-4.
  12. Suganthi V, Vikneshwari K, Thivya G. Prevalence of hypomagnesemia in neonatal seizures in a tertiary care hospital in South India. J Pediatr Res.2017; 4(01):64-68.doi:10.17511 /ijpr.2017.01.13.
  13. Sameer Kumar Jain. Study of the clinical profile of neonatal seizures. June 2015;2(6):336-338.
  14. Shah, G. S. et al. “ Clinico-Biochemical profile of neonatal seizure.” Journal of Nepal Paediatric Society28.1(2008):7-9.
  15. Iype M, Prasad M, Nair PM, Geetha S, Kailas L. The newborn with seizures a follow up study. Indian pediatr 2008;45:749-52.

Corresponding Author

Dilip Kumar

Junior Resident, Department of Paediatrics and Neonatology, RIMS, Ranchi, India