Publication:

Clinico-etiological profile and neurodevelopmental outcome of newborns with neonatal seizures at a tertiary care hospital in North India

Background Neonatal seizures are a common neurological disorder in newborns and significantly impact neurodevelopmental outcomes. The international league against epilepsy (ILAE) task force recently revised the classification of neonatal seizures, emphasizing the role of electroencephalography (EEG) in diagnosis and management. Seizures are categorized into electroclinical and electrographic-only types, excluding clinical events without an electrographic correlation.

Methods This prospective cohort study was conducted at the 500-Bedded Government Children’s Hospital, a tertiary care centre affiliated with Government Medical College, Srinagar. Neonates admitted with seizures from May 2024 to October 2024 were enrolled. Follow-up was conducted in the high-risk neonatal outpatient department (OPD) at 3 and 6 months, assessing neurodevelopment using the Amiel-Tison neurological examination.

Results Of 120 neonates, hypoxic-ischemic encephalopathy (HIE) (45.83%) was the leading cause, followed by metabolic disturbances (33.3%), meningitis (11.6%), postnatal epilepsy (5%), intraventricular haemorrhage (2.5%), and acute bilirubin encephalopathy (1.66%). Six cases were lost to follow-up, and eight neonates died due to seizure-related complications. Among the 106 surviving cases, 69.8% had normal neurodevelopment, while 30.2% exhibited abnormalities (mild: 13.2%, moderate: 11.3%, severe: 5.6%).

Conclusions Poor prognostic factors included preterm birth, low APGAR score, prolonged resuscitation, early-onset seizures, status epilepticus, abnormal neurological exam, and abnormal EEG or neuroimaging findings. HIE was the most frequent cause, highlighting the need for enhanced antenatal, perinatal, and postnatal care and early intervention to improve long-term outcomes.