DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20170711

Clinical, etiological, biochemical, microbiological and neurosonogram factors in related with neonatal seizures in Visakhapatnam, India

Marpi Suryaprasada Rao, Gavara Chinna Rao, Ayesha Sultana, Putrevu Jagannadha Karthik

Abstract


Background: Neonatal seizure is a common neurological problem in the neonatal period. Detection of seizure, its etiology, and clinical types is important for guiding therapy. A varied number of conditions are capable of causing seizures in the neonatal period. The aim was to study biochemical, microbiological and, nurosonogram factors related with neonatal seizures in Visakhapatanam, India.

Methods: The study was carried out in the Department of Paediatrics, Andhra medical college, King George Hospital, Visakhapatnam, Andhra Pradesh. The study was done to assess the biochemical changes, nurosonogram factors and microbilogical organisms implicated in neonatal seizures.

Results: The present study is descriptive in nature where clinical spectrum of neonatal seizures in neonates was studied. 1500 neonates were admitted in NICU during the study period, among them 200 (13.3%) developed neonatal seizures. Etiology in majority of the cases of neonatal seizures was hypoxic ischemic encephalopathy (45%) followed in frequency by intracranial haemorrhage (14%), meningitis (12%), hypoglycaemia (11%), hypocalcaemia (4%) and others (14%). The most common organism implicated in neonatal seizures was Escherichia coli (36%), followed by Klebsiella (30%), staphylococcus aureus (19%), Streptococci agalactiae (7%) and unknown (8%). Meningitis accounted for 12% of neonatal seizures. Most common biochemical abnormalities noted were hypoglycemia, hypocalcaemia and hyponatremia.

Conclusions: Biochemical abnormalities may significantly contribute to seizure activity and possibly correction of these abnormalities may play a significant role in seizure control. A biochemical work up is necessary for all cases of neonatal seizures. Appropriate treatment with antibiotics is essential. Examination of cerebrospinal fluid is essential work up in cases of neonatal seizures. Neurosonogram had good potential in predicting neurological outcome in neonates with perinatal asphyxia. Neurosonogram should be incorporated in the routine evaluation of seizures. 


Keywords


Biochemical, Microbiological, Neonatal seizures, Neurosonogram

Full Text:

PDF

References


Rennie JM. In: Rennie JM, editor. Roberton’s Text Book of neonatology, 4th ed. Churchill Livingstone, Elsevier; 2005:1080-1087.

Zupana ML. Neonatal seizures. Pediatr Clin. 2004;51:961-78.

Gleason CA, Devaskar S. Avery’s diseases of the newborn. 2012;9:901-19.

MC Cabe BK, Silveira DC, Cilio MR. Reduced neurogenesis after neonatal seizures. J Neuroscience. 2001;6:2094-103.

Kleigman, Stanton, St. Geme, Schor, Berhman, Nelson textbook of paediatrics. 2012;19:2033-2037.

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

Estan J, Hope PL. Unilateral neonatal cerebral infarction in full term infants. Arch Dis Childhood. 1997;76:88-93.

Goldberg HJ. Neonatal convulsions: a ten year review. Arch Dis Childhood. 1982;57:633-5.

Kliegman RM, Behrman RE, Jenson HB, Stanton BF. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, editors. Nelson Textbook of Pediatrics, 18th ed. Saunders; 2007:2471.

Ronnen GM, Penny S. The epidemiology of clinical neonatal seizues in newfoundland; Canada: a five year cohort. Annals Neurol. 1995;38:518-9.

Andre M, Matisse M, Vert P. Neonatal seizures eccnt aspects. Neuropediatr. 1998;19;202-7.

Lein JM, Towers CV, Quiligan EJ. Term early onset neonatal seizures: obstetric characteristics; etiological classification and perinatal care. Obst Gyne. 1995;85:163-9.

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

Keen JH. Significance of hypocaleaemia in neonatal convulsions. Arch Dis Childh. 1969;44:356.

Airede IK. Neonatal seizures and a 2 year neurological outcome. J Trop Pediatr. 1991;37:313-7.

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

Bergman I, Painter MJ, Hirsch R. Outcome in neonates with convulsions treated in ICU. Annals Neurol. 1983;14:642-67.

Ortibus EL, Sum JM, Hahn JS. Predictive value of EEG for outcome and epilepsy following neonatal seizures. Electroencephalogr Clin Neurophysiol. 1996;98:175-85.