A study of clinico-biochemical profile of neonatal seizure: A tertiary care hospital study

Background: Seizure is the most frequent sign of neurologic dysfunction in the neonate. Biochemical disturbances occur frequently in neonatal seizures either as an underlying cause or as associated abnormalities. Early recognition and treatment of biochemical disturbances are essential for optimal management and satisfactory long-term outcome. The aims were to study the biochemical abnormalities in neonatal seizures and to describe the clinical presentation, time of onset and its relation to etiology of neonatal seizures. Materials and methods: The present study included 125 neonates presenting with seizures admitted to neonatal unit. Detailed antenatal, natal and postnatal history was taken and examination of baby was done. Then relevant investigations including biochemical parameters were done and etiology of neonatal seizures and their associated biochemical abnormalities were diagnosed. Results: In the present study out of 125 neonates studied. 112 were full-term of which, 97 (77.6%) were AGA and 15 (12%) were SGA, 11(8.8%) were preterm and 2 (1.6%) was post-term babies. 121 (96.8%) were hospital deliveries and 110 (88%) were spontaneous vaginal deliveries. 78 (62.4%) were with birth weight > 2.5 kg. In our study, 90 (72%) cases had on set of seizures within first 3 days. The highest number was seen on first day of life 70(56%). Subtle seizures were the most common type of seizures in our study 52 (41.6%). Birth asphyxia was the most common cause of neonatal seizures in our study 68(54.4%), followed by neonates meningitis 21 (16.8%) and metabolic disorders 12 (9.6%). The most common biochemical abnormality detected in neonatal seizures in Hypocalcemia and Hypoglycemia. Conclusions: Hypoxic ischemic encephalopathy was the commonest etiology of neonatal seizures and in them most of the seizures had on onset in the first 72 hours. Overall focal clonic and subtle seizures were the commonest seizure types encountered. Hypocalcemia was the commonest biochemical abnormality in primary metabolic seizures. Biochemical abnormalities were commonly associated with other etiologies like asphyxia, intracranial hemorrhage and meningitis; hence these should be actively sought for and treated for optimal seizure control.