CLINICOPATHOLOGICAL STUDY OF NEONATAL SEIZURE WITH SPECIAL REFERENCE TO NEUROIMAGING: A TERTIARY CARE HOSPITAL BASED STUDY
Background: Seizures are most common and distinct clinical manifestation of neurologic dysfunction in the newborn. Its frequency is around 1.5-14/1000 neonates. The occurrence of seizure is positively correlated with structural brain damage and its consequent sequelae are later stages of life. Therefore, we need to initiate an early diagnostic workup to determine the causes. This study was conducted to determine the etiology of neonatal seizure as well as to find out how neuroimaging is useful in early diagnosis.
Aims and Objectives: The study was carried out with the objectives to find out the etiology of neonatal seizure, especially by using the neuroimaging facilities and to look at the spectrum of brain lesion.
Materials and methods: Hospital based observational study conducted over a period of 2 years (August 2015 to July 2017) at neonatal wing of SCB Medical College, Cuttack, India. All newborns with history of seizure and those who developed seizure during hospital stay were included in the study. Detailed antenatal histories, examination of the newborn and clinical detail of each seizure episode were recorded. Various data obtained were displayed in tables, charts, statistical analysis of the observations were done using percentages, averages etc.
Results: Out of 365 cases which had seizure, 233 (63.8%) were males. Term babies (60.76%) and babies weighing more than 2500 gms (57.44%) showed seizures in this study. Most (60.42%) of the cases were born by vaginal delivery who had seizure afterwards. Hypoglycemia, as a cause was found in only 4% of cases. HIE was the commonest cause (51.8%) followed by metabolic abnormalities (23.2%). Most of them showed abnormality in TC-USG, CT-Brain, MRI brain.
Conclusion: Most common cause of neonatal seizure is HIE and in maximum cases it is seen in first 72 hours of life. Screening of high risk pregnancies should be strengthened and early referral should be arranged. Imparting NRP training to all health caregivers and improvement of NICU standard in tertiary care centre will reduce the morbidity and mortality.
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