Profile of Neonatal Seizures and its Correlation with Serum Sodium Levels: A Prospective Cross-sectional Study

Abstract

Introduction: Neonatal seizures have detrimental effect on the immature developing, neonatal brain despite aetiological factors. Also, they can denote systemic diseases or altered biochemical milieu. Maintaining electrolyte balance is vital to the functioning of central nervous system and has either direct or indirect impact on neuronal stability. Aim: To estimate the serum sodium levels in neonates presenting with seizures and to correlate the serum levels with clinical manifestations and to delineate its aetiological factors. Materials and Methods: It was a prospective cross-sectional study conducted on 76 neonates admitted in tertiary level care NICU with seizures and evaluated with detailed history and clinical examination. They were subjected to serum sodium level estimation coupled with other relevant investigations to delineate the definitive aetiology. These parameters were recorded in a predesigned, pretested structured questionnaire and the obtained data was analysed statistically by Chi-square test using SPSS version 20. Results: Of the 76 neonates enrolled, 59.2% (n-45) neonates had hyponatremia, of them 17.7% (n-8) had severe hyponatremia. Drowsiness was significantly more frequent in hyponatremic neonates (p<0.001). Hyponatremia manifested more often among preterm neonates with statistical significance (p=0.020). Also, mortality was significantly high in neonates with hyponatremia (p=0.003). Similarly, hyponatremia was found to be significantly more frequent in neonates with Hypoxic Ischemic Encephalopathy (HIE) (p<0.001). Conclusion: Hyponatremia was manifested in 59.2% of the neonates with seizures. Severity and duration of hyponatremia is an important prognostic marker of neonatal seizures, so should be managed immediately.

Keywords

• drowsiness
• hyponatremia
• hypoxic ischemic encephalopathy
• preterm