Dhanyalaxmi N, Vinod Kumar M. S
BACKGROUND Seizures are a common neonatal neurologic emergency, affecting approximately 1-4 per 1000 live births. The first 28 days of life (defining the neonatal period) represents the period of greatest seizure hazard during human life span. The aim of the study is to evaluate the aetiology, clinical profile and EEG profile neonatal seizures. MATERIALS AND METHODS A prospective Hospital based observational study was conducted including 205 neonatal infants presenting with seizures in Government Tertiary Teaching Hospital, Kozhikode, Kerala for a period of one year between January 1, 2008 and December 31, 2008 (1 year). The demographic data, clinical presentations, laboratory reports and result of treatment were observed, analysed and reported. RESULTS 205 new born infants were admitted in NICU with seizures. 17,121 babies including inborn and out born infants took treatment in this Hospital. Out of which 205 infants who developed seizures were included in this study. The incidence of seizures is 4.2 per 1000 among inborn babies. There were 126 male infants and the remaining 79 female infants. The gestational age of the mother was full term in 183 (89.3%) and only 2% of the babies were less than 32 weeks of gestation. The antenatal risk factors leading to seizures in infants was none in 169 (82.4%) mothers. 131 (63.9%) infants were born by normal delivery, by lower segment caesarean section in 47 (22.9%), vacuum extraction in 13 (06.3%) and forceps delivery & assisted breach in 07 (3.4%) of the infants. The birth weight was more than 2500 grams in 144 (70.24%), 2000 to 2500 grams in 40/205 infants (19.51%) and 100 to 2000 grams in 18 (08.78%) infants. CONCLUSION The overall incidence of neonatal seizures in babies born in our hospital was 4.2 per 1000 live births. Perinatal asphyxia was the most common cause of neonatal seizures, followed by hypoglycaemia. Tonic seizures were the most common type of seizures followed by subtle seizures. Among the babies whose EEG was done, abnormal EEG was recorded in 9.5%. Mortality was highest in babies who developed seizures in first 24 hours of life and in babies born by assisted breech delivery.
