Abstract

Background: The most vulnerable period of life to develop seizures is the neonatal period. These events very often signify serious damage or malfunction of the immature developing central nervous system. Neonatal seizures may arise as a result of diverse etiologies and can have varied presentations.

Aims and Objective: Our study was aimed to find etiological factors, time of onset, clinical manifestations and various outcomes of neonatal seizures.

Methods: There were 110 neonates admitted in the NICU of a tertiary care centre in metropolitian city, with history of convulsions during the study period of 24 months from November 2016 to October 2018. Detailed antenatal history and baseline characteristics of convulsing neonate 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. Venous blood was collected as soon as possible and blood glucose, total serum calcium levels, Na+, K+, Mg and P-levels were done immediately after baby had seizures and before instituting any treatment. Data was described as mean ± SE and %age. SPSS 22.0 and MS Excel software were used for data analysis.

Results: Hypoxic ischemic encephalopathy was the commonest etiology of neonatal seizures followed by neonatal meningitis. Majority of Hypoxic ischemic encephalopathy patients presented with seizures in the first 72 hrs. of life. Subtle seizures were the commonest seizure types encountered. Hypoglycaemia was the commonest biochemical abnormality in primary metabolic seizures. Hypocalcaemia was the next commonest abnormality and most common outcome was Residual neurological abnormality followed by Epilepsy.

Conclusions: Hypoxic ischemic encephalopathy was the commonest etiology with subtle seizures being the commonest clinical types encountered. Hypoglycaemia was the most frequent biochemical abnormality found and most common outcome was residual neurological abnormality.