FREQUENCY, ETIOLOGICAL PROFILE AND MORTALITY OF NEONATAL SEIZURE DISORDERS.

Objective: To determine the frequency, etiological profile and mortality in neonates with seizure disorders. Study Design and setting: prospective study at National Institute of Child Health (NICH) Karachi from January 15th 2011 to 16th September 2011. Material and Method: A total of 115 neonates (1 -28 days) with various types of seizures were enrolled after explaining purpose and procedure of the study, consent was taken from parents. Their detailed history, physical examination and appropriate investigations were recorded on a predesigned proforma. Data was analyzed using descriptive statistics. Results: Out of a total 3240 admissions, 115 neonates (3.54%) presented with seizures. Birth asphyxia was the leading cause and found in 45(39.13%) of neonatal seizure disorders (NSDs). Hypoglycemia and hypocalcaemia was found in 35(30.43%) of the cases while 18 (15.65%) had infections like meningitis and sepsis. The common type of seizures observed were subtle (44.35%) followed by focal (27.83%), clonic (20.87%) and myoclonic types (6.95%).The overall mortality was 26 %. Brain malformations, Intracranial hemorrhage, kernicterus, birth asphyxia and infections were responsible for the mortality in 66.67%, 42.85%, 40%, 37.77% and 27.77% of cases respectively. There was no death attributed to metabolic causes. Conclusion: In this study frequency of neonatal seizure disorders observed was 3.54%. Birth asphyxia, metabolic causes and infections has been observed to be the common cause of seizures in neonates. Brain malformation, intracranial hemorrhage, kernicterus, birth asphyxia and infections were significant contributors to mortality. Metabolic group had a favourable outcome. [ABSTRACT FROM AUTHOR]