Neonatal seizures: clinical manifestations and etiology
Keywords:
neonatal seizures, convulsion, clinical classification, characteristics, intracranial hemorrhage, hypoxic ischemic encephalopathy, metabolic disturbances
Abstract
Background Neonatal seizures or fits are signs of central ner-vous system (CNS) diseases, metabolic disorders, or other dis-
eases disrupting the CNS. Neonatal seizures are poorly classi-
fied, under-recognized and often difficult to treat. It is important to
recognize the type of neonatal seizures that might be the only sign
of a CNS disorder.
Objective To recognize the type and etiology of neonatal sei-
zures in several hospitals in Jakarta.
Methods This was an observational case series study on full-term
and preterm infants who had seizures during hospitalization in Cipto
Mangunkusumo, Harapan Kita, and Fatmawati Hospitals between
January-June 2005. Neonatal seizures were defined as seizures
occurring in the first 28 days of life of a term infant or 44 completed
weeks of the infant’s conception age of preterm infant.
Results There were 40 neonates who born within the study period
and had seizures. Girls were outnumbered boys. Most neonates
were full-term with birth weight of more than 2500 grams. Analy-
ses were done on 38 neonates with epileptic and non-epileptic
seizures, while the other two who had mixed clinical manifestation
were not included. Most seizures occurred in the first 3 days of life
(23/38). The most common type was focal clonic (12/14) followed
by general tonic (11/24) and motor automatism or subtle (10/24).
The most common etiology was hypoxic ischemic encephalopa-
thy (HIE) (19/38) followed by metabolic disturbances, mainly hy-
pocalcaemia (11/38).
Conclusion Common types of seizures in neonates were focal
clonic, general tonic, and motor automatism (subtle). The most
common etiology was HIE followed by metabolic disturbances,
mainly hypocalcaemia
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TS, Ismael S, editors. Buku ajar neurologi anak. Jakarta:
IDAI; 1999. p. 253-73.
2. Hill A. Neonatal seizure. Pediatr Rev 2000;21:117-21.
3. Shet RD. Neonatal seizure. Available from: http://
www.emedicine.com/neonatal seizures-neurology.html.
Accessed September 22, 2001.
4. Scher MS, Aso K, Beggarly ME, Hamid M, Steppe DA,
Painter MJ. Electrographic seizures in preterm and full-
term neonates: Clinical correlates, associated brain
lesions, and risk for neurologic sequelae. Pediatrics
1993;91:128-34.
5. Neonatal seizures. Available from: http://www.
icondata.com/health/pedbase/ index.htm. Accessed
September 22, 2001.
6. Menkes JH, Sankar R. Paroxysmal disorders. In: Menkes
JH, Sarnat HB, editors. Child neurology. 6th ed. Phila-
delphia: Lippincott William & Wilkins; 2000. p. 919-
1007.
7. Shet RD. Electroencephalogram confirmatory rate in
neonatal seizures. Pediatr Neurol 1999;20:27-30.
8. Pellock JM. Seizures and epilepsy in infancy and
chilhood. In: Devinsky O, editor. Neurologic clinics.
Philadelphia: WB Saunders; 1993. p. 755-71.
9. Hendarto SK, Ismael S, Lumban Tobing SM, Lazuardi
S. Some aspects of neonatal convulsions. Paediatr
Indones 1974;14:11-20.
10. Legido A, Clansy RR Berman PH. Neurologic outcome
after electrocephalographically proven neonatal sei-
zures. Pediatrics 1991;88:583-96.
11. Brunquell PJ, Glennon CM, Dimario FJ, Lerer T,
Eisenfeld L. Prediction of outcome clinic seizure type
in newborn infants. Pediatr 2002;140:707-12.
12. Ronen GM, Penney S, Andrews W. The epidemiology
of clinical neonatal seizure in Newfoundland: A popu-
lation-based study. Pediatr 1999;134:71-5.
13. Wong M. Pediatric epilepsy center: Neonatal seizures.
Available from: http://www.neuro.wusti.edu/epilepsy/pe-
diatric/articleneonatalsz.htm. Accessed August 30, 2005.
14. Paradisis M. Department of neonatal medicine proto-
col book Royal Prince Alfred Hospital: Neonatal sei-
zure. Available from: http://www.cs.nsw.gov.au/rpa/
neonatal /html/newprot/seizures.htm. Accessed August
30, 2005.
15. Volpe JJ. Neonatal seizures. In: Volpe JJ, editor. Neu-
rology of the newborn. 4th ed. Philadelphia: WB
Saunders; 2001. p. 178-208.
16. Rennie JM. Neonatal seizures. Eur J Pediatr 1997;
156:83-7.
17. Pressler RM. Neonatal seizures. Available from: http:/
/www.epilepsy.org.uk/pages/articles/show_article.cmf?
id =29. Accessed September, 13th 2005.
18. Mizrahi EM, Kellaway P. Characterization and classifi-
cation. In: Placito M, editor. Diagnosis and manage-
ment of neonatal seizures. Philadelphia: Lippincott
Raven, 1998. p. 15-34.
Published
2016-10-18
How to Cite
1.
Widiastuti D, Mangunatmadja I, Tambunan T, Suradi R. Neonatal seizures: clinical manifestations and etiology. PI [Internet]. 18Oct.2016 [cited 25Apr.2024];46(6):266-0. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/955
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Received 2016-10-17
Accepted 2016-10-17
Published 2016-10-18
Accepted 2016-10-17
Published 2016-10-18
