Etiological Profile and Neurodevelopment Outcome of Neonatal seizure

Abstract

Introduction Neonatal 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. Methods We 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. Results During 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

Keywords

• hypoxic ischemic encephalopathy, Apgar score, seisezure, developmental delay