MAGNITUDE, RISK FACTORS, CLINICAL TYPES AND OUTCOME OF PATIENTS ADMITTED WITH NEONATAL SEIZURES IN NEONATAL INTENSIVE CARE UNIT OF A TERTIARY CARE CENTRE IN GUJARAT, INDIA
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 3359-3366
AbstractBackground: This study was undertaken to estimate the incidence, etiological factor, time of onset & clinical types of neonatal seizures in our setup and to study the biochemical abnormalities among the different types of neonatal seizures in our setup.
Methods: This is a hospital based prospective observational study conducted in neonatal ICU, department of paediatrics, BMCRI during period of January 2020 to March 2022.
Results: Total number of patients which developed neonatal seizures were 82 in our study. The proportion of neonatal seizures among NICU admission of inborn patients were 10.8%. Out of 82 babies of neonatal seizures, 45 (54.8%) were males and 37(45.12%) were females in the ratio of 1.2:1, with male preponderance. Out of 82 babies who developed neonatal seizures, it was found that 50(60.9%) were pre-term babies, 28(34.14%) were term babies and 4(4.87%) were post-term babies. In this study out of 82 babies, 45 neonates (54.8%) were LBW babies and 37 (45.12%) were of >=2.5kg birthweight. Out of 82 neonates, in 35 (42.6%) neonates seizure occurred between 24-72hrs whereas in 28 (34.14%) neonates seizure occurred in <24hrs and in 19 (23.17%) babies seizure occurred in >72hrs which shows that most of seizures were observed between 24-72hrs of life. In this study, out of 82 cases, neonates with subtle seizures were 40(48.78%), neonates with tonic seizures were 32(39.02%), neonates with focal clonic were 8(9.75%) and the multifocal clonic seizures were 2(2.43%). This shows that subtle seizures were most common followed by tonic seizures. It was found that out of 82 cases of neonatal seizures in this study, maximum cases 35(42.6%) were of birth asphyxia, followed by 15 cases of isolated hypoglycemia, (18.29%),
10(12.19%) cases were of neonatal meningitis/septicemia, 9(10.9%) cases were of isolated hypocalcemia, 10(12.19%) cases were of ICH (intracranial haemorrhage). There were 3(3.65%) cases of unknown causes of neonatal seizures. 2Out of 82 cases, 24 (29.26%) babies expired in spite of taking all efforts, and 58 (70.7%) babies were discharged successfully.
Conclusion: Neonatal seizures were more common in preterm, LBW. Birth asphyxia was the most common cause of all neonatal seizures followed by hypoglycemia. Subtle seizures were the commonest type of seizure observed followed by tonic. Subtle seizures were more common in 24-72 hours of life. Most common biochemical abnormality found in neonatal seizures is hypoglycemia followed by hypocalcemia.
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