Clinico-etiological profile of seizures in term and near-term neonates: tertiary care hospital based observational study


  • Garima Verma Department of Pediatrics, Eras Lucknow Medical College and hospital, Lucknow, Uttar Pradesh, India
  • Sumaiya Shamsi Department of Pediatrics, Eras Lucknow Medical College and hospital, Lucknow, Uttar Pradesh, India
  • Umesh Pathak Department of Pediatrics, LLRM Medical College, Meerut, Uttar Pradesh, India



Asphyxia, Etiology, Neonatal seizures


Background: Neonatal period is very important for development of immature brain and it is also most vulnerable period for development of seizures. Seizures have varied etiology as well as presentation during neonatal period. Considering this we planned this study with objective of finding incidence, etiology, type and time of onset of seizures and their correlation along with short term outcome.

Methods: It is a prospective observational study done in level 2 NICU set up of Government Medical College from November 2008 to September 2009. Total 115 term and near term neonates (≥35 weeks of gestation) presenting in NICU with seizures were enrolled in study. All relevant details were recorded on performa and investigations were sent. Data was described as mean±SD and %. SPSS 13 software was used as data analysis.

Results: Incidence of seizures came out to be 6.1% of total NICU admission, which was more in male appropriate for gestational age (AGA) babies and those who were born vaginally, extramural and to primiparous mother. Birth asphyxia was most common etiology of seizures and majority presented within 24 hours of birth and meningitis was most important cause of seizure after 7 days of life. Subtle seizures were most common clinical type of seizure in the present study. Risk factor for poor neurological outcome came out to be Hypoxic Ischemic Encephalopathy (HIE).

Conclusions: Hypoxic ischemic encephalopathy was most important etiology of neonatal seizures and most important risk factor for poor neurological outcome and subtle seizures being most common clinical type of seizure.



Volpe JJ. Neonatal seizures. Neurology of the new- born. Philadelphia, PA: WB Saunders; 2001;178- 214.

Airede KI. Neonatal seizures and a two-year neurological outcome. J Trop Pediatr. 1991;37:313-7.

Nunez JL, Alt JJ, McCarthy MM. A novel model for prenatal brain damage. Long term deficits in hippocampal cell number and hippocampal- dependent behaviour following neonatal GABA receptor activation. Exp Neurol. 2003;181:270-80.

Sarnat HB, Sarnat MS. Neonatal encephalography following foetal distress. A clinical and encephalographic study. Arch Neurol. 1976;33:696- 705.

Mercuri E, Cowan M, Rutherford D, Pennoch J, Dubowitz L. Ischemic and haemorrhagic brain lesions in new-borns with seizures and normal Apgar scores. Arch Dis Child. 1995;73:F67-74.

Scher MS. Destructive brain lesions of presumed foetal onset: antepartum causes of cerebral palsy. Paediatr. 1991;88:896-906 .

Scher MS, Hamid MY, Steppe DA. Ictal and interictal durations in preterm and term neonates. Epilepsia. 1993;34:284-8.

Sheth RD, Hobbs GR, Mullett M. Neonatal seizures: Incidence onset and etiology by gestational age. J Perinatol. 1999;19:40-3.

Holmes GL, Gairsa JL, Chevassus Au Louis N, Ben-Ari Y. Consequences of neonatal seizures in the rat: morphological and behavioral effects. Ann Neurol. 1998;44:845-85.

Wasterlain C. Recurrent seizures in the developing brain are harmful. Epilepsia. 1997;38:728-34.

Mirzahi EM, Kellaway P. Characterisation and classification of neonatal seizures. Neurol. 1987;37:1837-44.

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

Ment LR, Freedman RM. Neonates with seizures attributed to perinatal complications. Am J Dis Child. 1982;136:548-50.

Asindi AA, AntiaObong OE, Ibia EO. Neonatal seizures in Nigerian infants. Afr J Med Sci. 1995;24:243-8.

Singh M. Neonatal Seizures. In: care of the new Delhi. Sagar Publications; 1999:340-43.

Eriksson M, Zetterström R. Neonatal convulsions. Incidence and causes in the Stockholm area. Acta Pedict Scand. 1979;68:807-11.

Seay AR, Bray PF. Significance of seizures in infants less than 2500 gms. Arch Neurol. 1977;34:381.

Ronen GM, Penney S, Andrews W. The epidemiology of clinical neonatal seizures in Newfoundland: a population-based study. J Pediatr. 1999;134(1):71-5.

Cockburn F, Brown JK, Belton NR, Forfar JO. Neonatal convulsions associated with primary disturbance of calcium, phosphorus, and magnesium metabolism. Arch Dis Child. 1973;48(2):99-108.

Fredrichsen C. Tetany in a sucking infant with latent osteitis fibrosa in the mother. Lancet. 1939;1:85-6.

Intyrel M, Boss S, Va T. Parathyroid hormones and magnesium homeostasis. Nature. 1963;198:1058-60.

Bagla J, Garg H, Gulati RK, Gupta PP. Clinicoetiology profile of neonatal seizures in tertiary care Level II neonatal intensive care unit. Indian J Child Health. 2017;4(3):383-86.

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

Mizrahi EM, Kellaway P. Characterization and classification of neonatal seizures. Neurol. 1987;37(12)1837-44.

Scher MS. Controversies regarding neonatal seizure recognition. Epileptic Disord. 2002;4(2):139-58.

Dað Y, Fýrat AK, Karakaº HM, Alkan A, Yakýncý C, Erdem G. Clinical outcomes of neonatal hypoxic ischemic encephalopathy evaluated with diffusion-weighted magnetic resonance imaging. Diagn Interv Radiol. 2006;12:109-14.

Robertson C, Finer N. Term infants with hypoxic– ischemic encephalopathy outcome at 3.5 years. Dev Med Child Neurol. 1985;27:473-84.

Holt DE, Halket S, de Louvois J, Harvey D. Neonatal meningitis in England and Wales, 10 years on. Arch Dis Child Fetal Neonatal Ed. 2001;84:F85-9.

Stevens JP, Eames M, Kent A, Halket S, Holt D, Harvey D. Long term outcome of neonatal meningitis. Arch Dis Child. 2003;88:179-84.

Klinger G, Chin CN, Beyenne J, Perlman M. Predicting the outcome of neonatal bacterial meningitis. Pediatr. 2000;106:477-82.






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