Clinical and etiological profile of neonatal seizures in neonatal intensive care unit: a tertiary care hospital-based study

Anuj S. Sethi; Neeraj K. Sharma; Om S. Chaurasiya; Mimansa Bharti

doi:10.18203/2349-3291.ijcp20261542

Authors

Anuj S. Sethi Department of Pediatrics, MLB Medical College, Jhansi, Uttar Pradesh, India
Neeraj K. Sharma Department of Pediatrics, MLB Medical College, Jhansi, Uttar Pradesh, India
Om S. Chaurasiya Department of Pediatrics, MLB Medical College, Jhansi, Uttar Pradesh, India
Mimansa Bharti Department of Obstetrics and Gynaecology, MLB Medical College, Jhansi, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20261542

Keywords:

Neonatal seizures, Hypoxic-ischemic encephalopathy, Hypoglycemia, Hypocalcemia, Neonatal intensive care unit

Abstract

Background: Neonatal seizures are the most common neurological emergency in the neonatal period and are associated with significant morbidity and mortality. Biochemical abnormalities represent an important and potentially reversible cause of neonatal seizures, particularly in resource-limited settings where electroencephalographic monitoring is often unavailable. This study aimed to evaluate the clinico-etiological profile of neonatal seizures among neonates admitted to the neonatal intensive care unit (NICU).

Methods: This one-year prospective observational study was conducted in the neonatal unit of a tertiary care hospital in the Bundelkhand region. Term and preterm neonates with first-onset seizures within 28 days of life and no prior antiepileptic exposure were included, while those with major congenital malformations, jitteriness, tetanic spasms, or previous anticonvulsant treatment were excluded. Detailed clinical characteristics, seizure types, etiological factors, and biochemical parameters, including blood glucose and serum electrolytes, were systematically evaluated.

Results: Out of 1475 NICU admissions, 188 neonates developed seizures (incidence 12.74%); 150 cases were included for analysis. Most neonates (82%) presented within the first three days of life, with a male predominance (60%). Subtle seizures were the most common type (40%). Hypoxic-ischemic encephalopathy (HIE) (31.3%) was the leading etiology, followed by sepsis (27.3%). Biochemical abnormalities were observed in 28% of cases, with hypoglycemia (11.3%) and hypocalcemia (10%) being the most frequent. Preterm neonates showed a higher incidence of metabolic disturbances. All neonates with isolated biochemical abnormalities recovered completely following appropriate correction. Overall mortality was 9.3%, predominantly among neonates with HIE and sepsis.

Conclusion: HIE remains the leading cause of neonatal seizures. Biochemical abnormalities are common, reversible contributors and are associated with excellent outcomes when promptly corrected. Routine metabolic evaluation in all neonates with seizures is essential to improve prognosis and minimize unnecessary anticonvulsant use.

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