Publication:

Clinical profile of neonatal seizures with special reference to biochemical abnormalities

Background Neonatal seizures are clinically significant because very few are idiopathic. Biochemical disturbances occur frequently in neonatal seizures either as an underlying cause or as associated abnormalities. Early recognition and treatment of these biochemical disturbances are essential for optimal management and satisfactory long term outcome.  The main of the study is to assess the importance of biochemical abnormalities in neonatal seizures and   to evaluate the clinical profile, time of onset and its relation to etiology of neonatal seizures.

Methods A prospective observational study including neonates presenting with seizures admitted to the NICU of a tertiary level hospital, Bangalore, from December 2012 to August 2014. Detailed history and examination of baby followed by relevant investigations including biochemical parameters were done .The etiology of neonatal seizures, time of onset and its relation to etiology and the associated biochemical abnormalities were established in each case.

Results Out of the 110 neonates studied, birth asphyxia was the commonest cause of neonatal seizures in 66 (60%) cases, followed by neonatal sepsis and metabolic disorders. Primary metabolic abnormalities occurred in 13(11.8%) cases of neonatal seizures, most common being hypoglycemia 9 (69.3%) followed by hypocalcaemia. Associated biochemical abnormalities were seen in 33 (30%) cases with hyponatremia 13 (39.3%) being most common followed by hypoglycemia. These were most often seen with Hypoxic- ischaemic-encephalopathy.

Conclusions Biochemical abnormalities are common in neonatal seizures and often go unrecognized. These abnormalities may significantly contribute to seizure activity and hence a biochemical work up is necessary for all cases of neonatal seizures.