Clinical and etiological assessment of neonatal seizures in term neonates
Dr. Kripa Nath Mishra, Dr. Jaimala, Dr. Chandan Kumar Pathak
Neonatal seizures are common and may be the first manifestations of neurological dysfunction after a variety of insults. It is critical to recognize neonatal seizures to determine their etiology and to treat them. Neonatal seizures present with varying manifestations like generalized tonic, multifocal clonic and subtle activity. Newborn babies do not manifest febrile convulsions. Therefore, it is important to recognize the seizures and treat it, as delay in recognition and treatment may lead to brain damage. The time of onset of seizure has relationship with the etiology and prognosis. Hence based on above findings the present study was planned for Clinical and Etiological Assessment of Neonatal Seizures in Term Neonates. The present study was planned in Department of Pediatric, SNCU, Darbhanga Medical College and Hospital, Laheriasarai, Darbhanga, Bihar. In the present study 120 clinically diagnosed with the seizures before 28 days of life were evaluated. Clinical criteria for diagnosing neonatal convulsions were , (a) focal, multifocal, or generalised clonic movement (b) tonic posturing with or without abnormal gaze (c) subtle seizures and spontaneous paroxysmal repetitive motor or autonomic phenomenon like lip smacking, chewing, paddling, swimming, cyclic movements or respiratory abnormalities. The data generated from the present study concludes that perinatal asphyxia is the most common cause of neonatal seizures among term neonates in our setup. The other causes followed in order are metabolic (hypoglycaemia, hypoglycaemia, hypomagnesaemia and hyperbilirubinemia), septicaemia, intracranial haemorrhages and brain malformations. Hypocalcaemia was the commonest biochemical abnormality in primary metabolic seizures. Biochemical abnormalities were commonly associated with other etiologies like asphyxia, intracranial hemorrhage and meningitis; hence these should be actively sought for and treated for optimal seizure control.