Clinco-etiological Profile and Predictors of Outcome of Neonatal Seizures: A Prospective Observational Study from Egypt

Background: Neonatal seizures are the most prevalent neurological disorders. In Egypt,  the characteristics and neurodevelopmental outcomes of neonatal seizures have not been sufficiently explored. Methods: The present study was conducted on ۱۲۰ full-term and preterm newborns from  October ۲۰۱۶ and October ۲۰۲۰.  The adverse outcomes of cerebral palsy, mortality, developmental delay, and/or epilepsy have been considered. The associations between adverse outcomes and ۱۳ variables were analyzed. Results: Hypoxic-ischemic encephalopathy (HIE) (۳۴.۲%) was the most common etiology for neonatal seizures, followed by intracranial hemorrhage (۲۵.۸%). The predominant seizure type was subtle (۵۷.۵%), preceded by clonic seizure (۱۶.۷%). Moreover,  ۷۲ neonates had a normal outcome, ۱۴ (۶۰%) cases had minor functional disabilities, and ۲۷ (۲۲.۵%) newborns survived with one or more neurodevelopmental abnormalities (۶ cases had cerebral palsy, and ۲۱ newborns had global developmental delay), with a ۱۷.۵ % mortality rate. Based on the univariate analysis, ۱۰ variables were associated with an unfavorable outcome; nonetheless, only three variables, namely metabolic acidosis, abnormal cranial ultrasonography findings, and the presence of congenital heart disease, were independent predictors as illustrated by multivariate logistics. Conclusion: As evidenced by the obtained results, HIE and intracranial hemorrhage were the most common causes of neonatal seizures. Perinatal insult, prematurity, seizure onset <۲۴ hours, low Apgar score at ۱ min, myoclonic or mixed seizure, the efficacy of the anticonvulsant therapy, abnormal cranial U/S, metabolic acidosis, abnormal electroencephalography (EEG)  pattern, and the presence of congenital heart disease were the most reliable predictors of adverse outcome.    

Keywords:

Infants , neonate , Preterm , Outcome , Seizure