Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Background: Incidence of seizures is highest during the neonatal period, and it is considered a medical emergency that necessitate proper clinical and etiological assessment. Objective: To figure out the different etiologies and incidence of neonatal seizures among newborns admitted at NICU Cairo University hospital, thus helping for appropriate diagnosis and proper management. Methodology: The present study included 60 neonates presenting with seizures admitted at NICU Cairo University hospital during the period of one year from May 2014 to May 2015. Baseline data was collected including antenatal history, perinatal history and evidence of HIE (hypoxic ischemic encephalopathy), description of seizures and complete examination. For all cases, serum glucose, calcium, sodium, magnesium, complete blood counts, serum creatinine, liver function tests, ABGs, cranial ultrasound and EEG were done. Second line investigations (blood culture, screening for inborn error of metabolism) were done in selected neonates. Modes of management were also recorded. Descriptive statistics were applied for analysis. Results: Among total 60 cases of neonatal seizures, 24 (40%) cases had Hypoxic ischemic encephalopathy, followed by septicemia in 10(16.7%) cases, Interventricular hemorrhage& Hypocalcaemia were detected in equal ratio 8(13.3%)cases, Intracranial hemorrhage in 4(6.7%) cases, Kernicterus and metabolic were found in 3(5%)&2(3.3%) cases respectively. Majority of cases presented with myoclonic (36.7%) and mixed (28.3%) type of seizures Conclusion: The commonest cause of seizures in this study was perinatal asphyxia with majority presenting in the first 72hrs. Myoclonic seizures were the commonest type of seizure observed

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