The causes of seizure in neonates referred to children hospital and specialized clinics of Tabriz university of medical sciences

Abstract

Seizures are the most common and obvious manifestation of neurological disorders in infancy. The most likely happen in the first month of life. About a third of it happened on the first day and another third in the first week. There is a high risk of mortality and neurological impairment in these infants, which can be associated with life disorders. It is important to know the cause of the seizure to be able to effectively treat the cause and provide parents with a more accurate prediction of the baby. Objective: The aim of this study was to find the causes of seizures in infants and the frequency of each of these causes. Materials & Methods: This study was performed in Tabriz Children's Educational and Medical Center. In this retrospective cross-sectional study, all neonates who were hospitalized in the neonatal ward and NICU of Tabriz Educational and Medical Center from April 1, 2017 to the end of 2016, with the final diagnosis of neonatal seizures, were included in the study. Demographic information as well as information about birth and disease, including test and paraclinical results, were collected based on written reports in patients' records and using a checklist. Results: Data from 111 patients were evaluated. 63 were boys and 48 were girls. The mean gestational age at birth was 37 ± 2 weeks, and the mean age of seizures in infants was 36 ± 13 days, which were not statistically significant. The most common causes of seizures were idiopathic neonatal seizures with 42 cases, ischemic-hypoxic encephalopathy with 27 cases, sepsis in 10 cases and intracranial hemorrhage with 10 cases. Other cases included hypoglycemia, polycythemia, cryptogenic epilepsy, cerebrovascular thrombosis, and hypocalcemia. In 111 patients, convulsive movements were confirmed. The most common manifestations were tonic, clonic, tonic-clonic, myoclonic, focal and subtle seizures. Tonic and clonic seizures were significantly associated with idiopathic and hypoxemic-ischemic encephalopathy. In terms of causes of seizures, electroencephalography showed better diagnostic power in cases of hypoxic-ischemic encephalopathy and intracranial hemorrhage. Risk factors for neonatal seizures were family history, cesarean delivery, preterm birth, and male gender. Hypoxia at birth and low birth weight were not significantly associated with seizures.