A Study of Clinical Features and Prognosis of Neonatal Seizures

ABSTRACT

PURPOSE: Neonatal seizures are relatively common and the symptoms are clinically different from those in older children and adults. The goal of this study is to help understand neonatal seizures by analyzing the etiology, clinical features, method of diagnosis and prognosis of the affected patients in our hospital. METHODS: Twenty six cases with neonatal seizures who were admitted to the neonatal intensive care unit, Dongguk University Hospital from January 1999 to October 2008 were retrospectively reviewed. They were evaluated with risk factors, neurologic examinations, laboratory data, neuroimaging studies, EEG findings, seizure types, response to treatment, and outcomes. RESULTS: Subtle seizure came out to be the most common seizure type(9 patients 34.6 %). The cause of neonatal seizures were hypoxic-ischemic encephalopathy(9 patients 34.6 %), intracranial hemorrhage(8 patients 30.8%), electrolyte imbalance(8 patients 30.8%), meningitis(7 patients 26.9%). Nineteen out of 25 patients showed abnormal lesion on neuroimaging studies such as intracranial hemorrhage, periventricular leukomalacia, brain infarction, etc. Abnormal EEG findings were noted in 19 patient(73.1%). Phenobarbital was tried as a first line antiepileptic drug and phenytoin was added if it failed to control seizures. The overall outcome was relatively good except for those with abnormal EEG findings. CONCLUSION: Neonatal seizures signify underlying diseases. Recognition of etiology is often helpful in prognosis and treatment. Neuroradiological and EEG findings are important in predicting neurologic outcomes in newborns with seizures.