Etiological Spectrum of Neonatal Seizures in Neonatal Intensive Care Unit in Tertiary Care Hospital

Authors

  • Muhammad Ihsan Department of Pediatrics, CMH Abbottabad, KP, Pakistan.
  • Amjad Iqbal Department of Pediatrics, CMH Abbottabad, KP, Pakistan.
  • Hasham Khan Department of Pediatrics, CMH Abbottabad, KP, Pakistan.
  • Hizbullah Khan Burki Department of Pediatrics, CMH Abbottabad, KP, Pakistan.
  • Akhlaq Uddin Department of Pediatrics, CMH Abbottabad, KP, Pakistan.
  • Sahibzada Aziz Ullah Department of Pediatrics, CMH Abbottabad, KP, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i7.2000

Keywords:

Neonatal Seizures, Etiology, Sepsis, Hypoxic-ischemic Encephalopathy, Polycythemia, NICU

Abstract

Background: Neonatal seizures rank as one of the most sensitive neurological emergent conditions presenting most often as foreboders of subbing pathologies that need immediate recognition, as well as treatment for prevention of late neurodevelopmental sequelae, particularly in resource-poor settings. Objective: To determine the frequency of the causes of neonatal seizures in neonatal intensive care unit in tertiary care hospital. Study Design: Descriptive cross-sectional study. Duration and Place of Study: The study was conducted from January to May 2025 in the Neonatal Intensive Care Unit, Department of Pediatrics, CMH Abbottabad. Methodology: A total of 110 neonates aged 1 to 28 days presenting with clinical seizure activity were enrolled. Seizure types were classified into subtle, clonic, tonic, and myoclonic based on observable features. Etiological factors including sepsis, hypoxic-ischemic encephalopathy (HIE), hypoglycemia, hypocalcemia, meconium aspiration syndrome (MAS), and polycythemia were investigated using defined clinical and laboratory criteria. Results: The most frequent seizure type was subtle (48.2%). Sepsis was the leading etiology (80.9%), followed by HIE (44.5%), MAS (24.5%), hypocalcemia (22.7%), hypoglycemia (17.3%), and polycythemia (14.5%). A statistically significant association was observed between age group and polycythemia (p=0.002), while other etiologies showed no significant association with clinical variables. Conclusion: Sepsis remains the predominant cause of neonatal seizures, with subtle seizures being the most common type.

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References

1. Kaminiów, K., Kozak, S., & Paprocka, J. (2021). Neonatal seizures revisited. Children, 8(2), 155.

https://doi.org/10.3390/children8020155

2. Hashish, M., & Bassiouny, M. R. (2022). Neonatal seizures: Stepping outside the comfort zone. Clinical and Experimental Pediatrics, 65(11), 521-528.

https://doi.org/10.3345/cep.2022.00115

3. Kim, E., Shin, J., & Lee, B. K. (2022). Neonatal seizures: Diagnostic updates based on new definition and classification. Clinical and Experimental Pediatrics, 65(8), 387-397.

https://doi.org/10.3345/cep.2021.01361

4. Trowbridge, S. K., Condie, L. O., Landers, J. R., Bergin, A. M., Grant, P. E., Krishnamoorthy, K., Rofeberg, V., Wypij, D., Staley, K. J., & Soul, J. S. (2023). Effect of neonatal seizure burden and etiology on the long‐term outcome: Data from a randomized, controlled trial. Annals of the Child Neurology Society, 1(1), 53-65.

https://doi.org/10.1002/cns3.8

5. Spenard, S., Salazar Cerda, C. I., & Nevzat Çizmeci, M. (2024). Neonatal seizures in low- and middle-income countries: A review of the literature and recommendations for the management. Turkish Archives of Pediatrics, 59(1), 13-22.

https://doi.org/10.5152/turkarchpediatr.2024.23250

6. Zhou, K. Q., McDouall, A., Drury, P. P., Lear, C. A., Cho, K. H., Bennet, L., Gunn, A. J., & Davidson, J. O. (2021). Treating seizures after hypoxic-ischemic encephalopathy—Current controversies and future directions. International Journal of Molecular Sciences, 22(13), 7121.

https://doi.org/10.3390/ijms22137121

7. Okazaki, K., Nakamura, S., Koyano, K., Konishi, Y., Kondo, M., & Kusaka, T. (2023). Neonatal asphyxia as an inflammatory disease: Reactive oxygen species and cytokines. Frontiers in Pediatrics, 11.

https://doi.org/10.3389/fped.2023.1070743

8. Raturi, A., & Chandran, S. (2024). Neonatal sepsis: Aetiology, pathophysiology, diagnostic advances and management strategies. Clinical Medicine Insights: Pediatrics, 18.

https://doi.org/10.1177/11795565241281337

9. De Rose, D. U., Ronchetti, M. P., Martini, L., Rechichi, J., Iannetta, M., Dotta, A., & Auriti, C. (2024). Diagnosis and management of neonatal bacterial sepsis: Current challenges and future perspectives. Tropical Medicine and Infectious Disease, 9(9), 199.

https://doi.org/10.3390/tropicalmed9090199

10. Hensler, E., Petros, H., Gray, C. C., Chung, C., Ayala, A., & Fallon, E. A. (2022). The neonatal innate immune response to sepsis: Checkpoint proteins as novel mediators of this response and as possible therapeutic/Diagnostic levers. Frontiers in Immunology, 13.

https://doi.org/10.3389/fimmu.2022.940930

11. Huang, Y., Chao, Y., & Lee, I. (2022). Syndromic and non-syndromic etiologies causing neonatal hypocalcemic seizures. Frontiers in Endocrinology, 13.

https://doi.org/10.3389/fendo.2022.998675

12. Phattraprayoon, N., Ungtrakul, T., & Tangamornsuksan, W. (2021). The effects of different types of steroids on clinical outcomes in neonates with meconium aspiration syndrome: A systematic review, meta-analysis and GRADE assessment. Medicina, 57(11), 1281.

https://doi.org/10.3390/medicina57111281

13. Kallimath, A., Kolkur, K., Malshe, N., Klimek, J., & Suryawanshi, P. (2024). Hemodynamics in neonates with polycythemia before and after partial exchange transfusion: An observational study. Frontiers in Pediatrics, 11.

https://doi.org/10.3389/fped.2023.1296184

14. Rastogi, S., Rai, P. L., & Prasad, P. L. (2017). Clinicoetiological profile of neonatal seizures in a tertiary care hospital. Indian Journal of Child Health, 04(04), 587-590.

https://doi.org/10.32677/ijch.2017.v04.i04.029

15. Patel, S., & Mehta, N. (2023). Study of clinical and etiological profile of neonatal seizures in tertiary care hospital. National Journal of Medical Research, 13(01), 7-12.

https://doi.org/10.55489/njmr.13012023932

16. Ali Hassan, H., Ismaieel, A., & Elsherbeiny Qotb, E. (2020). CLINICO-ETIOLOGICAL PATTERN OF NEONATAL SEIZURES. Al-Azhar Journal of Pediatrics, 23(3), 1022-1037.

https://doi.org/10.21608/azjp.2020.127064

17. Chesti, M. S., Shahzad, N., Chaman, S., & Gazala, S. (2021). Clinical profile, etiology, type and outcome of neonatal seizures: A hospital-based study. International Journal of Contemporary Pediatrics, 9(1), 104.

https://doi.org/10.18203/2349-3291.ijcp20214947

18. Almuqbil, M., Alrumayyan, Y., Alattas, S., Baarmah, D., AlTuwaijri, W., AlRumayyan, A., AlRifai, M. T., Al Madhi, A., Al-shehri, H., & Alsaif, S. (2023). Neonatal seizures: Etiologies, clinical characteristics, and radiological features: A cross-sectional study. Medicine, 102(37), e35185.

https://doi.org/10.1097/md.0000000000035185

19. Najeeb, S., Qureshi, A. M., Anis-ur-Rehman, Ahmad, F., Shah, S., Khan, A. Y., & Siddiqui, T. S. (2012). Aetiology and types of neonatal seizures presenting at Ayub Teaching Hospital Abbottabad. PubMed, 24(1), 33–37.

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Published

2025-07-15

How to Cite

Ihsan, M., Iqbal, A., Khan, H., Khan Burki, H., Akhlaq Uddin, & Aziz Ullah, S. (2025). Etiological Spectrum of Neonatal Seizures in Neonatal Intensive Care Unit in Tertiary Care Hospital. Indus Journal of Bioscience Research, 3(7), 604-609. https://doi.org/10.70749/ijbr.v3i7.2000