Etiological Profile and Neurodevelopment Outcome of Neonatal seizure

Abstract

IntroductionNeonatal seizures are the most common manifestation of neurological disorders in newborn period. It is an important determinant of outcome as well. This study aims to delineate the etiological profile and neurodevelopmental outcome of neonatal seizure. It is also aimed to identify the predictors of neurodevelopmental outcome in survivors.
 MethodsWe recruited consecutively 117 neonates with clinically proven seizures admitted in XXXXX hospital, between February 2014 to February 2016. All of them underwent neurological diagnostic testincluding complete blood count, electrolytes, EEG, CSF analysis, neuroimaging depending upon the etiology of seizure in newborn period. After discharge, all infant with neonatal seizure underwent regular neurological examination at least 3 times within first year of life. We tested prognostic value of adverse outcome including developmental delay, post neonatal seizure, vision and hearing impairment.ResultsDuring the study period among total 954 neonates admitted in NICU and neonatal ward, 117 (12.26%) developed clinical seizures. The most common cause of neonatal seizure was hypoxic ischemic encephalopathy 69(59%), followed by infection 20 (17.09%) and metabolic disturbances collectively constituted 16(13.7%). The outcomes were mortality 16(13.7%), post neonatal seizure 18(15.4%), developmental delay 31(26.5%), vision impairment 19(16.2%) and hearing impairment 26 (22.2%).Low Apgar score at 1 minute (p=0.03), low Apgar score at 5 minute (p=0.001), early onset seizure (p<0.001), intractable seizure (p<0.001)and more than one drug used for seizure control (p=0.001) were early prognostic factors for adverse outcome.Key words: hypoxic ischemic encephalopathy, Apgar score, seizure, developmental delay

Neonatal Seizure Pattern, Outcome, and its Predictors Among Neonates Admitted to NICU of Ayder Comprehensive Specialized Hospital, Mekelle, Tigray, Ethiopia

“…In our study it was also found that; 69.7% of new-borns had an early-onset seizure which occurs before 72 hours. This finding is comparable to the findings in the study by Shah et al, 9 Rastogi et al's study (66.67%), 4 Dongol Singh et al's study (70.9%), 15 and Baudou et al's study (78%). 18 The explanation is as perinatal asphyxia is the most common comorbidity in those studies and seizures in perinatal asphyxia are usually early onset.…”

“…Our study found that the burden of neonatal seizures was 9.6% of neonatal admissions, which is comparable to the finding of Shah et al's study (9.95%) 9 and Mwaniki et al's study (9%) 6 but slightly lower than the results of Dongol Singh et al's study (12.26%) 15 and Sudia et al's study (11.7%). 16 This low incidence can be because we were only able to document clinically obvious seizures and we did not practice diagnostic EEG recording for neonates who are at risk of seizure which possibly subclinical seizures can be missed.…”

“…Similar studies were described by Lai et al, Dongol Singh et al and Laurel et al regarding early onset seizure and prolonged labor as predictors of poor neonatal outcomes but jaundice was not found to be a predictor of poor outcome in those studies. 15 , 17 , 19 This could be due to the number of patients with seizures who had also jaundice, in our study neonates with seizures who were also jaundiced at presentation were 36 (23.2%) of all neonates with seizures ( Table 2 ), but in Dongol Singh et al and Hsuan lai et al studies, none of the neonates involved in the study had jaundice at presentation or during a hospital stay.…”

“…Early-onset seizures, asphyxia-induced, and poorly controlled seizures appear to have the worst prognosis. 15 …”

Determinants of neonatal Seizure among neonates admitted to neonatal intensive care units in the Awi Zone Hospitals, 2023: A multi-center unmatched case control study.

“…The odds of developing neonatal seizure were nearly six times higher in neonates admitted within 24 hours of birth as compared to neonates 7-28 days old. This aligns with a study conducted in Landon (17), Kathmandu University in Dhulikhel (18), the University of Gonder in Ethiopia (12), and Dhaka Medical College in India (15). This is because immediately after birth, neonates are challenged with an extra uterine environment, and their organs such as the brain are not completely grown.…”