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J Pediatr Neurosci. 2014 May;9(2):97-9. doi: 10.4103/1817-1745.139261.

Neonatal seizures: Predictors of adverse outcome.

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1
Department of Pediatrics, Sree Gokulam Medical College and Research Foundation, Thiruvananthapuram, Kerala, India.

Abstract

CONTEXT:

Early detection of predictors of adverse outcome will be helpful for neonatologists to plan management, follow up and rehabilitation in advance so that neurological disability can be minimised.

AIMS:

The purpose of this study was to determine the factors affecting the adverse outcome of neonatal seizures.

SETTINGS AND DESIGN:

This is a prospective study conducted in the neonatal unit of a tertiary care hospital. One hundred and eight newborns consecutively admitted with seizures were included in this study.

MATERIALS AND METHODS:

Data was collected regarding perinatal history and seizure and evaluated for etiology. We conducted a retrospective analysis to identify the factors associated with adverse outcome after neonatal seizures.

STATISTICAL ANALYSIS USED:

Chi-square test with degree of freedom = 1 was used to find the variables significantly associated with adverse outcome (P < 0.05).

RESULTS:

Gestational age, birth weight, Apgar score at 5 min, seizure onset <24 hrs, status epilepticus, radiological findings and EEG findings were significantly associated with outcome.

CONCLUSION:

Mortality and severe neurological impairment after neonatal seizure is associated with prematurity, LBW, low Apgar score at 5 min, etiologies like meningitis, sepsis, severe HIE, brain malformations, grade 3 or 4 IVH or intracranial haemorrhage, seizure onset <24 hours, presence of status epilepticus, severely abnormal radiological and EEG findings.

KEYWORDS:

Hypoxia-ischemia; neonatal seizures; new born; preterm infants; prognosis; seizures/diagnosis/etiology/mortality

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