Study of the clinical profile and etiology of neonatal seizures in a tertiary care centre of Bundelkhand region

Kartar S. Sodhi; Sapna Gupta; Aradhana Kankane; Rajni Gautam

doi:10.18203/2349-3291.ijcp20260823

Authors

Kartar S. Sodhi Department of Paediatrics, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India
Sapna Gupta Department of Paediatrics, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India
Aradhana Kankane Department of Paediatrics, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India
Rajni Gautam Department of Paediatrics, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20260823

Keywords:

Neonatal seizures, Hypoxic-ischemic encephalopathy, Tertiary care, Bundelkhand region

Abstract

Background: Neonatal seizures are among the most common neurological emergencies, contributing to significant morbidity and mortality. Their causes vary, including hypoxic-ischemic encephalopathy (HIE), infections, metabolic disorders, and intracranial hemorrhage. Seizures in neonates often result in long-term neurodevelopmental challenges, making early diagnosis and intervention crucial. This study aims to assess the prevalence, clinical presentation, etiological factors in neonatal seizures in a tertiary care center in the Bundelkhand region.

Methods: This prospective observational study was conducted at the neonatal intensive care unit (NICU) of Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, from May 2023 to April 2024. A total of 140 neonates diagnosed with seizures and hospitalized for more than 24 hours were included. Data collection involved seizure type, onset, clinical and neurological assessments, and investigations such as electroencephalography (EEG), cranial ultrasound, and metabolic screening.

Results: Among the 140 neonates, 69.3% were outborn, with HIE (65.7%) being the most common cause, followed by septicemia (20.7%) and metabolic disorders (5%). Multifocal clonic seizures (37.9%) were most frequent, followed by subtle seizures (34.3%).

Conclusions: Neonatal seizures remain a major concern, with HIE being the leading cause. A significant proportion of affected neonates experience neurodevelopmental delays, emphasizing the need for early recognition, timely intervention, and long-term follow-up. The findings draw attention to Improved neonatal care and early intervention at the time of delivery in form of widespread neonatal resuscitation training program for all the health care staff who care for newborn at the time of delivery.

References

Volpe JJ, Inder TE, Darras BT, de Vries LS, du Plessis AJ, Neil JJ, et al. Volpe's Neurology of the Newborn. Elsevier. 2018.

Panayiotopoulos CP. The Epilepsies: Seizures, Syndromes and Management. Chapter 5, Neonatal Seizures and Neonatal Syndromes. Oxfordshire (UK): Bladon Medical Publishing. 2005.

Jensen FE. Neonatal seizures: an update on mechanisms and management. Clin Perinatol. 2009;36(4):881-900.

Dzhala VI, Talos DM, Sdrulla DA, Brumback AC, Mathews GC, Benke TA, et al. NKCC1 transporter facilitates seizures in the developing brain. Nat Med. 2005;11(11):1205-13.

Spenard S, Ivan Salazar Cerda C, Çizmeci MN. Neonatal Seizures in Low- and Middle-Income Countries: A Review of the Literature and Recommendations for the Management. Turk Arch Pediatr. 2024;59(1):13-22.

Glass HC. Hypoxic-Ischemic Encephalopathy and Other Neonatal Encephalopathies. Continuum (Minneap Minn). 2018;24(1):57-71.

Heljic S, Uzicanin S, Catibusic F, Zubcevic S. Predictors of Mortality in Neonates with Seizures; a Prospective Cohort Study. Med Arch. 2016;70(3):182-5.

Yadav S, Agrawal P, Sharma VK, Rekha, Yadav SL. Study of etiological factors and immediate outcomes of neonatal seizure among preterm and term neonate in a tertiary health centre of Northern India. Int J Contemp Pediatr. 2023;10(9):1406-11.

Salehiomran MR, Naseri M, Mahzari M. Etiology and clinical findings in neonates with seizures in Babol, Northern Iran. Iran J Child Neurol. 2018;12(2):47-52.

Sudia S, Meena KR, Meena AK, Narayan S, Meena D. Clinical and etiological profile of neonatal seizures in a tertiary care hospital in Western India. Int J Contemp Pediatr. 2015;2(3):232-6.

Kang SK, Johnston MV, Kadam SD. Acute TrkB inhibition rescues phenobarbital-resistant seizures in a mouse model of neonatal ischemia. Eur J Neurosci. 2015;42(10):2792-804.

Abhishek CK, Reddy KS, Kalikiri P. Clinical and etiological profile of neonatal seizures in a tertiary care hospital. Int J Contemp Pediatr. 2020;7(8):1603-7.

Saral S, Kumar N, Sharma N. Clinical profile and outcome of neonatal seizures in a tertiary care hospital in North India. Int J Contemp Med Res. 2017;4(6):1313-6.

Ferriero DM. Neonatal brain injury. N Engl J Med. 2004;351(19):1985-95.