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KMID : 0371619980140020257
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Journal of Wonkwang Medical Science
1998 Volume.14 No. 2 p.257 ~ p.267
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Clinical Study and Prognostic factors of Neonatal Seizures
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Oh Kwang-Soo
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Abstract
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Background: The convulsive phenomena are the most frequent of the overt manifestations of neonatal neurological disorders. It is very important to recognize neonatal seizures, to determine their etiology and to treat them for several reasons, such as seizure may be cause brain injury. The Purpose of this study is to help adequate treatment and predict prognosis by analysing clinical manifestations and factors related neonatal seizures.
Methods: Retrospective reviews were made on 65 cases of neonatal seizure who were admitted to the Department of Pediatrics, Wonkwang University School of Medicine from January 1995 to May 1998. The most valuable contributing factors among etiology, type of seizure, age of onset, sex, EEC findings for predicting the prognosis were assessed by using soft program of the SSPS/PC+ Discriminant analysis.
Results: 1) The most frequent causes of neonatal seizure was hypocalcemia(33.9%), and followed by hypoxic-ischemic encephalopathy(18.5%), hyponatremia(6.2%), unknown(9.2%), benign neonatal convulsion(4.6%), hypoglycemia(3.1%), intracerebral hemorrhage(1.5%), in order of frequency.
2) The time of onset of neonatal seizure was within 24 hours of postnatal age in 22 cases(33.8%), on 2nd and 3rd days in 24 cases(36.9%), 4th and 7th days 12 cases(18.5%).
3) The types of neonatal seizure were multifocal clonic(63.1%), subtle(16.9%), generalized tonic(10.8%), focal tonic(4.6%), focal clonic(3.1%), and myoclonic(1.5%) in order of frequency.
4) The Brain magnetic resonance imaging (MRI) was performed in 31 cases. Abnormal MRI findings were found in 17 (54.8%) and were subcortical hyperintensity and subdural hemorrhage in 4 cases, respectively, periventricular leukomalacia in 3 cases, status marmoratus in 2 cases, periventricular ischemia in 2 cases, and intraventricular hemorrhage and intracerebral hemorrhage in one case, respectively.
5) The electroencephalography(EEG) was done in 34 cases, and showed abnormal findings in 7 cases(20.6%). multifocal clonic and generalized tonic seizure were associated with abnormal EEC in 25.0% and 40%, respectively.
6) The follow-up examination were made on 56 patients(86.2%) during the period from 9 days to 17 months. 2 cases in hypoxic-ischemic encephalopathy 7 patients revealed cerebral palsy, and 1 case in hypocalcemia patient showed continous seizure disorder.
Conclusion: The most valuable prognostic factors among EEC findings, onset of seizure, sex, type of seizure, and etiology is EEC findings(P=0.0023).
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KEYWORD
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Neonatal seizure, prognostic factors
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