Shazia Memon1, Mohd M Hassan A Memon. 1. Department of Paediatrics, Liaquat University of Medical and Health Sciences, Hyderabad. shaziamemonap@hotmail.com
Abstract
OBJECTIVE: To determine the frequency, etiology, the clinical types, and outcome of seizures in neonates during the course of stay in the neonatal unit. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION: Pediatric Department, LMCH, from February 2000 to April 2001. PATIENTS AND METHODS: All neonates (1-28 days) presented with seizures during that period were included in the study. Their detailed history, physical examination, and appropriate investigations were recorded on a study proforma. RESULTS: Out of a total 680 patients, 100 patients presented with the seizures; this comprises the frequency of 14.7%. Male to female ratio was 2.1:1. Regarding gestational age, 65% were full-term, 31% were pre-term, and 4% were post-term. Regarding etiology, 40% patients had birth asphyxia; 14% had hypoglycemia; 12% were due to hypocalcaemia, 5% were due to intracranial hemorrhage (ICH), 4% had malformation, 10 % had infection /neonatal sepsis, and in 12%, the etiology was kernicterus. Among the patients with seizures, 45% were completely recovered and discharged and 15% patients had neurological deficit at the time of discharge. From the hospitalized 100 patients, 22% expired. The critical factors for the outcome were etiology, gestational age, birth weight, APGAR score, and clinical characteristics. Generally, birth asphyxia had poor, while metabolic causes had good prognosis. CONCLUSION: Frequency of seizures was higher in full term (65%) neonates than pre-term (31%). Among the etiological factors birth asphyxia was found to be the most common cause, and showed unfavorable outcome in this series. Common risk factors were low birth weight, pre-maturity, home delivery, pregnancy-induced hypertension and premature rupture of membranes.
OBJECTIVE: To determine the frequency, etiology, the clinical types, and outcome of seizures in neonates during the course of stay in the neonatal unit. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION: Pediatric Department, LMCH, from February 2000 to April 2001. PATIENTS AND METHODS: All neonates (1-28 days) presented with seizures during that period were included in the study. Their detailed history, physical examination, and appropriate investigations were recorded on a study proforma. RESULTS: Out of a total 680 patients, 100 patients presented with the seizures; this comprises the frequency of 14.7%. Male to female ratio was 2.1:1. Regarding gestational age, 65% were full-term, 31% were pre-term, and 4% were post-term. Regarding etiology, 40% patients had birth asphyxia; 14% had hypoglycemia; 12% were due to hypocalcaemia, 5% were due to intracranial hemorrhage (ICH), 4% had malformation, 10 % had infection /neonatal sepsis, and in 12%, the etiology was kernicterus. Among the patients with seizures, 45% were completely recovered and discharged and 15% patients had neurological deficit at the time of discharge. From the hospitalized 100 patients, 22% expired. The critical factors for the outcome were etiology, gestational age, birth weight, APGAR score, and clinical characteristics. Generally, birth asphyxia had poor, while metabolic causes had good prognosis. CONCLUSION: Frequency of seizures was higher in full term (65%) neonates than pre-term (31%). Among the etiological factors birth asphyxia was found to be the most common cause, and showed unfavorable outcome in this series. Common risk factors were low birth weight, pre-maturity, home delivery, pregnancy-induced hypertension and premature rupture of membranes.