Study of biochemical abnormalities in neonatal seizures with special reference to hyponatremia

Kamatham Madhusudhan, Nadavapalli Srinivasa Suresh, Talakola Ramesh Babu, Jampana Venkateswara Rao, Surisetti Bharath Kumar


Background:Biochemical abnormalities are commonly observed in neonates who are admitted in NICU with seizures. In these babies, biochemical abnormalities can be either primary or secondary. Secondary biochemical abnormalities are commonly observed in the presence of other obvious causes of seizures like HIE, meningitis etc. Hyponatremia, hypoglycemia and hypocalcemia are common metabolic disturbances found in neonates with seizures. The present study is intended to evaluate the incidence of various biochemical abnormalities especially hyponatremia.

Methods: It is an observational study done in a tertiary care centre, Gandhi hospital, Secunderabad, Telangana, India involving 120 babies admitted with seizures in NICU.

Results:Biochemical abnormalities were found in 52 babies with the most common primary abnormality being hypoglycemia mostly encountered in preterm babies and the most common secondary abnormality being hyponatremia seen mostly in term babies. Prompt identification of the biochemical abnormalities in neonatal seizures enables specific intervention by the treating doctor resulting in better neurological outcome.

Conclusions:Early detection and prompt management of hyponatremia would help in preventing occurrence of seizures and also help in avoiding over use of anticonvulsants in the management of seizures resulting in favourable neurological outcome with less long term morbidity.


Neonatal seizures, Hyponatremia, Term, Preterm, Biochemical abnormalities

Full Text:



Miller SP, Weiss J, Barnwall A, Ferriero DM, Latal HB, Ferrer RA et al. Seizure-associated brain injury in term newborns with perinatal asphyxia. Neurology. 2002;58(4):542-8.

Davis AS, Hintz SR, Van KP, Li L, Das A, Stoll BJ et al. Seizures in extremely low birth weight infants are associated with adverse outcome. J Pediatr. 2010;157(5):720-5.

Berg A, Jallon P, Preux P. The epidemiology of seizure disorders in infancy and childhood: definitions and classifications. Handbook of Clinical Neurology. Pediatric Neurology. 3rd edition. Elsevier, Amsterdam, Netherlands;2013:381-98.

Eril T, Hadzsiev K, Vincze O, Pytel J, Sulyok E. Hyponatremia and sensorineural hearing loss in preterm infants. Biol Neonate. 2001;79(2):109-12.

Volpe JJ. Neonatal seizures: Current concepts and revised classification. Pediatrics. 1989;84(3):422-8.

Kumar A, Gupta V, Kachhawaha JS, Singla PN. Biochemical abnormalities in neonatal seizures. Indian Pediatr. 1995;32(4):424-8.

Sood A, Grover N, Sharma R. Biochemical abnormalities in neonatal seizures. Indian J Pediatr. 2003;70(3):221-4.

Rose AL, Lombroso CT. A study of clinical, pathological, and electroencephalographic features in 137 full term babies with a long-term follow up. Pediatrics. 1970;45(3):404-25.

Calciolari G, Perlman JM, Volpe JJ. Seizures in the neonatal intensive care unit of the 1980’s types, etiologies, timing. Clin Pediatr. 1988;27:119-23.

Feldman W, Drummond KN, Klein M. Hyponatremia following asphyxia neonatorum. Acta Paediatr Scand. 1970;59(1):52-7.