IJSR International Journal of Scientific Research 2277 - 8179 Indian Society for Health and Advanced Research ijsr-6-4-10584 Original Research Paper A STUDY OF ETIOLOGY,ONSET AND CLINICAL MANIFESTATIONS OF NEONATAL SEIZURES Devjibhai K Vadher Dr. Dr Ketan Gadhavi Dr. April 2017 6 4 01 02 ABSTRACT

 Background: Neonatal seizures are clinically significant because very few areidiopathic. Further investigation leading to prompt diagnosis of the underlying condition is important because many of the etiologies have specific treatment. Time of onset of seizures has correlation with etiology.

 

Objectives: The objective of the present study is to know the etiology of neonatalseizures, to know the time of onset of neonatal seizures and its relation to etiology and to know the various types of seizures in neonates.

 

Methodology: The present study included 100 neonates presenting with seizuresadmitted in the NICU of hospitals attached to C.U.Shah Medical colleges,Surendranagar during the period of June 2013 to august 2014.Detailed antenatal, natal and post natal history were taken and examination of baby done and

 

HIE staged according to Modified Sarnat’s staging. Then relevant investigations were done and etiology of neonatal seizures were diagnosed.

 

Results: In the present study, out of 100 neonates studied, 94 were full–term, amongthese 73 were AGA and 21 were SGA. 5 were preterm. Male:Female ratio in our study was 1.7:1.

 

In our study onset of seizures within first three days of life were seen in 84 neonates (84%). After 3 days of life 16 neonates developed seizures (16%). Onset of seizures within first 3 days of life of had statistically significant correlation with birth asphyxia as the etiology with p<0.001.

 

Subtle seizures were the commonest type of seizures in our study (44 cases – 44%), followed by GTS (29 cases – 29%), multifocal clonic (11 cases – 11%) and focal clonic seizures (8 cases – 8%).

 

Birth asphyxia was the commonest cause of neonatal seizures in our study (74 cases

 

– 74%) followed by hypoglycemia (14 cases – 14%) and meningitis (8 cases – 8%). Out of 74 cases of birth asphyxia 35 (48.6%) mothers had prolonged second stage of labour and 18 (24.3%) had MSAF. Hypoglycemic seizures were more common in LBW babies with statistically significant p<0.001.


 


Conclusion: The recognition of etiology of neonatal seizures is often helpful withrespect to prognosis and treatment. The most common etiology for neonatal seizure is HIE and is frequently associated with perinatal risk factors. Onset of seizures during first 3 days of life has significant correlation with HIE as etiology. Hypoglycemic seizures are more common in LBW babies.

 

Subtle seizures are commonest type of clinical seizures, which is difficult to identify, therefore careful observation of at risk newborns is necessary.