Clinical-etiological profile of neonatal seizures and their outcomes in children's central teaching hospital

Abstract

Background: The most common newborn neurological abnormality is seizures. Full-term babies get neonatal seizures within 4 weeks, whereas preterm babies can have them up to 44 weeks after conception. About 3-6 per 1000 live births. Objectives to study clinical types, time of onset and to determine the etiology of neonatal seizures and response to treatment. Method: A prospective study of 78 neonates with clinically observed seizures was conducted at the neonatal ward in Child's Central Teaching Hospital, Baghdad, from May 1 to December 1, 2022. Detailed history and examination by a pediatrician were performed, analyzing variables such as age, sex, mode of delivery, seizure onset, presentation pattern, feeding method, maternal drug history, underlying causes, anticonvulsant response, and discharge state. Antenatal and prenatal histories, including maternal infections, gestational age, fetal distress, delivery complications, and hypoxic-ischemic encephalopathy, were documented. Laboratory and neuroimaging studies were conducted when indicated. Results: 87.2% of 78 patients (male: female ratio 1.2:1) were born at term. Most seizures (43.6%) occur in the first 72 hours of birth. This study found that tonic seizures were the most prevalent form (50%), followed by subtle (25.6%), focal (14.1%), and multifocal (10. 3%).In this research, hypoxic ischemic encephalopathy (HIE) caused 28.2% of newborn seizures, followed by meningitis (21.8%), sepsis (14.1%), hypocalcaemia (14.1%), hypoglycemia (11.5%), kernel icterus (5.1%), IVH (3.8%), and TORCH (1.33%). Phenobarbital alone (86.3%) and phenytoin (13.7%) caused a reaction. IVH caused most of these individuals' 9% death.Conclusion: Neonatal seizures are most prevalent in full-term male infants in their first 72 hours, and tonic seizures are the most common. Hypoxic ischemic encephalopathy causes most newborn seizures, followed by meningitis. Preterm newborns die most from intraventricular hemorrhage.