BIOCHEMICAL ABNORMALITIES IN NEONATAL SEIZURES IN A TERTIARY CARE RURAL TEACHING HOSPITAL OF SOUTH INDIA

Author: ARUNKUMAR A.R, SUDHA REDDY V.R., SUMATHI M.E., PUSHPALATHA K

Category: Clinical Sciences

Abstract:

Context : Seizures during neonatal period is a common problem. Biochemical abnormalities may be the underlying cause or they may be associated with other causes of seizures. Early recognition and management of biochemical disturbances in neonatal seizures is important to prevent further brain damage.

Aims : To analyse the serum biochemical abnormalities in neonatal seizures.

Settings and Design : Prospective study in a tertiary care rural teaching hospital of South India.

Material and Methods : 100 neonates with history of seizures were included in the study. Inclusion criteria consisted of all neonates (<28 days of life) admitted to NICU with history of seizures and those who developed seizures after admission. Apart from completed blood count (CBC), septic screening, blood for culture and sensitivity, serum levels of calcium (Ca), Phosphate (P), magnesium (Mg), sodium (Na), potassium (K) and blood glucose were measured as soon as possible after seizure and before institution of specific therapy.

Results : Out of 100 neonates with seizures, 69 were out born (referred to our hospital from outside) and 31 were inborn. Seizures occurred more frequently among term infants (78%). One or more biochemical abnormalities were observed in 82% of neonates with seizures. Hypoglycemia (44/82=53.65 %) was the most common abnormality followed by hypocalcemia (26/82=31.7%).

Conclusion : Hypoglycemia and hypocalcemia were the most common disturbances present not only as primary disorders but also associated with specific etiology. Early recognition and treatment is of utmost importance in order to decrease morbidity and mortality.

Keywords: Neonatal seizures, Biochemical abnormalities, Hypoglycemia, Hypocalcemia.