NEONATAL SEIZURES

ETIOLOGY, CLINICAL TYPES AND OUTCOME

Abstract

Introduction: Seizures in the neonates are quite different from those in older children and adults,
whereas seizures in preterm differ from those of term infant. Neonatal seizures are poorly organized and at times
inconspicuous, they also differ in origin from those of older children as they frequently arise in subcortical areas while
in older children they arise from cortex. Objective: To find out the frequency of seizures and determine the frequency
of various types of neonatal seizures among newborns admitted to Nishtar Hospital, Multan. Material and Methods:
Setting: Pediatric Unit-I, Nishtar Hospital, Multan. Duration: From May 1998 to December 2000. Sample size:200
cases. Results: Out of these 200 cases, 162(81%) were male and 38(19%) were female. Among the babies with
seizures, 163(81.5%) were full term, 25(12.5%) were preterm and 12(6%) were post-term. In relation to time of
presentation, 40(40%) patients presented within 24 hours, while 65(32.5%) within 72 hours of birth and remaining
55(27.5%) patients after 72 hours of birth. Among the etiological factors noted there were 100(50%) patients with birth
asphyxia, 40(20%) with infections, 30(15%) with metabolic problems, 18(9%) with intra-cranial hemorrhage and 6(3%)
patients had kernicterus. Cerebral malformations were noticed in 4(2%) cases and 2(1%) patients were diagnosed as
pyridoxine dependency. Regarding the type of seizures multi focal clonic seizures occurred in 100(50%) cases,
generalized tonic seizures in 56(28%) cases and subtle and focal clonic seizures in 22(11%) each. Sixty one 30.5%)
patients died during their hospital stay. Conclusion: Neonatal seizures indicate significant underlying disease.
Recognition of etiology is often helpful in prognosis and treatment.