CLINICO-AETIOLOGICAL PROFILE OF NEONATAL SEIZURES AND THEIR OUTCOMES IN A TERTIARY CARE HOSPITAL
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 15
Abstract
BACKGROUND Neonatal seizures defined as seizures occurring in first 28 days of life are one of the most common morbidity factors of admission in NICU. Incidence is 1.5 - 14/ 1000 neonates. Seizures often signify serious damage or malfunction of the immature developing central nervous system and contribute to sequelae in later life. Neonatal seizures may arise as a result of diverse aetiologies and can have varied presentations. Aims and Objectives- Our study is aimed at finding the incidence, aetiological factors and time of onset, clinical types and various biochemical abnormalities and outcome of babies admitted with seizures in our NICU. MATERIALS AND METHODS It is a prospective observational study for a period of one year, i.e. from July 2015 to Aug 2016, carried out in the Department of Paediatrics, Andhra Medical College and King George Hospital, Visakhapatnam, Andhra Pradesh. A total of 150 neonates with neonatal seizures who fulfilled the inclusion criteria were included in the study. RESULTS During the study period a total no. of 150 babies were admitted with neonatal seizures in our NICU, of which males were 91 (60.67%) and females were 59 (39.33%). Most of the babies with seizures were admitted within 24 hrs. of life, i.e. 77 (51.33%) followed by 48 - 72 hrs. 31 (20.67%) and the rest after 72 hrs. by 28 days 42 (28%). Commonest type of seizures observed were focal clonic seizures 59 (39.33%) followed by subtle 43 (28.66), myoclonic 27 (18%), tonic 10 (6%), multifocal 6 (4%) and GTCS 5 (35). Among the various aetiological causes of seizures, HIE is the commonest cause 79 (52.67%) followed by ICH 20 (13.33%), meningitis 18 (12%), hypoglycaemia 17 (11.33%), hypocalcaemia 12 (8%), hypomagnesaemia 5 (3.33%) and others 9 (6%). Commonest organism isolated was E. coli 44.5%. The total neonatal mortality rate of babies admitted with seizures was 12 (8%), of which HIE is the commonest cause 6 (50%) followed by ICH 3 (25%) and others 3 (25%). CONCLUSION The present study shows that perinatal asphyxia is the most common cause of neonatal seizures among neonates admitted for seizures in our NICU. The other causes followed in order are IVH, sepsis, metabolic (hypoglycaemia, hypocalcaemia) and brain malformations. Early identification of at-risk pregnancies, institutional delivery and aseptic precautions with timely resuscitation is recommended to reduce morbidity and mortality due to neonatal seizures.
Authors and Affiliations
Menni Chowdary Babu, Chakravarty B. S, Chaitanya N
Keywords
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- EP ID EP414466
- DOI 10.14260/jemds/2018/425
- Views 84
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