scholarly journals NEONATAL SEIZURES;

2018 ◽  
Vol 21 (05) ◽  
pp. 1048-1053
Author(s):  
Arshad Mahmood ◽  
Syed Qamar Zaman ◽  
Shahid Mahmud
Keyword(s):  
Cerebral Palsy ◽  
Neurodevelopmental Outcome ◽  
Birth Asphyxia ◽  
Unknown Etiology ◽  
Neonatal Seizures ◽  
Inborn Errors ◽  
Cross Sectional ◽  
Normal Delivery ◽  
Female Ratio

Objective: To study the types, etiology and long term neurodevelopmentaloutcome in neonates with seizures. Study Design: A descriptive cross-sectional study. Placeand Duration of Study: PNS Shifa Naval hospital Karachi from Jan 2011 to Feb 2014. StudyPopulation: Ninety six neonates of either gender presented with seizures at NICU PNS ShifaNaval hospital Karachi were studied. Method: All neonates with seizures were evaluated.The seizures were classified according to the simiology. They were investigated according toNICU protocol to confirm the underlying diagnosis and timely management. The patients afterdischarge were regularly followed up for one year to assess the long term neurodevelopmentaloutcome. Results: A total of 96 neonates with seizures were studied and it was observedthat 60 (62.5%) were male babies and 56 (58.33%) were term with a male to female ratio of1.6:1. Majority of the neonatal seizures were seen in 1stweek of life (85%). The most commontype of seizures was clonic 40 (41.67%) followed by subtle 20 (20.84%), mixed 16 (16.67%),tonic 10 (10.41%), myoclonic 5 (5.20%) and unclassified 5 (5.20%). Antiepileptics were usedin 82 (85.41%) patients. Phenobarbitone 49 (59.76%) was most commonly prescribed drug.The most common cause of seizures was birth asphyxia 48 (50%) followed by metabolic 16(16.68%), sepsis 10 (10.41%), intracranial hemorrhage 6 (6.25%), bilirubin encephalopathy 4(4.16%), inborn errors of metabolism 2 (2.08%), birth trauma 2 (2.08%) and unknown etiology 5(5.20%). 25 (26.04%) patients develop adverse neurodevelopmental outcome i.e. cerebral palsywith epilepsy 10 (40%) and cerebral palsy without epilepsy 05 (20%), developmental delay 10(40%). Mortality in the study was 12 (12.5%). Conclusions: Clonic seizures are commonestin neonates apart from infants and children who have GTCS. The most common etiology ofseizures in neonates is birth asphyxia. Phenobarbitone is still the most commonly prescribedantiepileptic. Quick assessment, timely diagnosis and aggressive management according tothe etiology are necessary to prevent the morbidity and mortality associated with neonatalseizures. Long term neurodevelopmental outcome is worse in patients with birth asphyxiaespecially with low Apgar score at 5 minutes. Normal delivery and birth asphyxia were the majorrisk factors for cerebral palsy

scholarly journals Metabolic and Electrolyte profile in Birth Asphyxia

2020 ◽  
Vol 7 (7) ◽  
pp. 331-336
Author(s):  
Dr. Abhishek Kumar Singh ◽  
◽  
Dr. Bhoopendra Sharma ◽  
Dr. Anita Mehta ◽  
Dr. Karm Chand Gandhi ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Birth Asphyxia ◽  
Cross Sectional Study ◽  
Metabolic Abnormalities ◽  
Neonatal Seizures ◽  
Inborn Errors ◽  
Cross Sectional ◽  
Medical College ◽  
Definition Of ◽  
Ischemic Encephalopathy

Introduction: The definition of birth asphyxia is given by the ACOG, AAP includes the existence of 3factors: Metabolic or mixed acidemia (pH<7) which is determined by umbilical cord arterial bloodsamples. The major causes of neonatal seizures are Hypoxic-ischemic encephalopathy (HIE), whichrepresents about 50% of the causes of neonatal seizures. Metabolic abnormalities, infection,intracranial hemorrhage, developmental anomalies, and other like inborn errors of metabolism areother causes of neonatal seizures. Material and Methods: A cross-sectional study. This is ahospital-based prospective study conducted at Nehru Hospital, BRD Medical College, Gorakhpur (UP)in the Neonatal Intensive Care Unit of the pediatric department. This study was conducted from July2018 to July 2019. Result: Prevalence of Hypocalcemia was 7.6%, Prevalence of hypernatremia was1.3%, Out of 315 patients 32 (10.2%) patients expired and 283 (89.8%) was successfullydischarged. Conclusion: No association between Hypocalcemia and Hypomagnesemia Prevalence ofhyponatremia was 6.3% and no association between hyponatremia and Hypomagnesemia. Theprevalence of hypernatremia was 1.3% and there was no association between hypernatremia andHypomagnesemia.

scholarly journals A CROSS-SECTIONAL STUDY OF CLINICAL PROFILE OF CEREBRAL PALSY PATIENTS VISITING A GOVERNMENT TERTIARY CARE HOSPITAL FROM MAHARASHTRA, INDIA

2020 ◽  
pp. 1-5
Author(s):  
Smita Mundada ◽  
Tejas Mandlecha ◽  
Prabha Khaire ◽  
Shilpa Pawar
Keyword(s):  
Cerebral Palsy ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Common Finding ◽  
Periventricular White Matter ◽  
Care Hospital ◽  
Cross Sectional ◽  
Female Ratio ◽  
History Of

Cerebral palsy has emerged as one of the major causes of childhood disability in India. In low and middle income countries there are gaps in knowledge in the spheres of epidemiological research, intervention and service utilization. AIMS AND OBJECTIVES: This study describes the clinical features associated problems of children with CP visiting a government tertiary care Hospital from Maharashtra, India. Materials and Methods: This was cross sectional retrospective observational study conducted on 78 children of cerebral palsy. Result: Among 78 enrolled children, maximum 50%(n=39) of children were between1-3yr age group with male to female ratio was 1.05:1. History of consanguinity was seen in 35.9% (n=28) subjects, 69.2%(n=54)of subjects were from the urban area. 78.2% (n=61) subjects were born term , 65.3%(n=51) cases had a history of NICU stay with the most common etiological factor being birth asphyxia seen in 38.4 %( n=30) subjects followed by sepsis in 29.5% subjects (n=23). Most common type of cerebral palsy was spastic 87.1% followed by dyskinetic 10.2%. Most of the participants were at GMFCS level IV and V (23.1% and 47.4% respectively). 78.2% subjects were having feeding problems, 43.6% had associated epilepsy. Majority of our subjects had Microcephaly (69.2%) and malnutrition (74.3%). MRI was done in only 34.6% of subjects with most common finding being periventricular white matter injury (PVWMI)). Conclusion: It is suggested that rehabilitation clinics should be set up for CP patients at every government medical college so that parents can be made aware of the disease, handicaps, prognosis, and management.

Prevalence and predictors of adverse outcomes in neonatal seizures

2021 ◽  
pp. 1-7
Author(s):  
K. Famra ◽  
P. Barta ◽  
A. Aggarwal ◽  
B.D. Banerjee
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Birth Asphyxia ◽  
Adverse Outcomes ◽  
Neonatal Seizures ◽  
Clinical Practices ◽  
Inborn Errors ◽  
Mortality And Morbidity ◽  
Low Birth Weight Babies

OBJECTIVES: Neonatal seizures are significant cause of neonatal mortality and morbidity. Current study was planned to study prevalence of adverse outcomes in neonatal seizures and identify its predictors. METHODS: This observational descriptive study was carried out on 220 neonates with seizures. Neonates who succumbed to illness/ death before investigations, or whose maternal records were incomplete were excluded. Blood sugar, serum calcium, serum electrolytes, and USG skull were done in all patients. CT scan, MRI and inborn errors of metabolism profile were done as and when indicated. Adverse outcomes were defined as death, phenobarbitone non responders, or abnormal examination at discharge. Antenatal, perinatal and neonatal predictors of adverse outcomes in neonatal seizures were evaluated. RESULTS: Out of 220 neonates with seizures 76(34.5%) had adverse outcomes. Very low birth weight babies (≤1500 gm) [OR 1.27(CI 0.57–2.84)], microcephaly [OR 5.93 (CI 0.55–64.41)], Apgar score≤3 at 5 minutes [OR 11.28(CI 14.18–30.45)], seizure onset within 24 hours [OR 5.99(CI 12.43–14.78)], meningitis [OR 2.63(CI 0.08–6.39)], septicemia [OR1.22(CI 0.45–3.31)] and abnormal cranial USG [OR 7.95(CI 12.61–24.22)] were significant predictors of adverse outcomes in neonates with seizures. CONCLUSION: Prematurity, very low birth weight, birth asphyxia, meningitis, septicemia and abnormal USG could predict adverse outcomes in neonatal seizures. Improved antenatal and neonatal clinical practices may help reduce adverse outcomes in these patients.

Birth Incidence of Cerebral Palsy in Tripoli, Libya: A Population-Based Study

2020 ◽  
pp. 1-5
Author(s):  
Ahmed Atia ◽  
Aya Abogrein ◽  
Maram Alssoghaiar ◽  
Mawada Akroush ◽  
Mawada Alsagheer
Keyword(s):  
Cerebral Palsy ◽  
Mode Of Delivery ◽  
Congenital Toxoplasmosis ◽  
Birth Asphyxia ◽  
Neonatal Infection ◽  
Population Based ◽  
University Hospital ◽  
Cross Sectional ◽  
Population Based Study ◽  
Background Population

Background: Population-based data in Libya on prevalence of cerebral palsy are limited. This study aimed to assess trends in cerebral palsy among infancy or premature attending pediatric hospitals in Tripoli city, Libya. Methods: In this population-based study, a cross-sectional method was used to screen for cerebral palsy at the department of pediatrics in both Tripoli University Hospital, and Tripoli Pediatric Hospital during the period from march to December 2019. Specialist physicians confirmed the diagnosis, obtained family history, and determined the subtype and main causes. Results: Out of 200 suspected patients, 64 of them were diagnosed with cerebral palsy. Incidence rate was 32%. Male children (n=33, 51.6%) were more affected than female (n=31, 48.4%). Regarding the mode of delivery, 34(53.1%) of patients were delivered normally by vaginal delivery, while 30(46.9%) of cases delivered by caesarian section. There were 9(14.1%) of cases preterm birth, whereas, most of the cases were full term 55(85.9%). Birth asphyxia was reported in 34 (53.1%) of cases. A total of 17(26.6%) of cases had genetic cause, 8(12.5%) of cases had history of neonatal infection (e.g. meningitis, congenital toxoplasmosis, pneumonia, sepsis, encephalitis), and 5(7.8%) of cases had other disorders including hyperthermia and asphyxia at late age. Conclusion: Given enhancements in neonatal survival, evidence of stability of cerebral palsy prevalence is encouraging. The persistence of higher cerebral palsy prevalence among children in Libya over time warrants further investigation.

scholarly journals Correlation of Thompson Score in Predicting Early Outcome of Newborn with Birth Asphyxia

2020 ◽  
Vol 18 (3) ◽  
pp. 406-410
Author(s):  
Sabina Shrestha ◽  
Sangita Puree Dhungana ◽  
Sujit Shrestha ◽  
Gentle Sunder Shrestha
Keyword(s):  
Neurodevelopmental Outcome ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Clinical Score ◽  
Hypoxic Ischemic Encephalopathy ◽  
Early Outcome ◽  
Medical College ◽  
A Prospective Study ◽  
Ischemic Encephalopathy

Background: Birth asphyxia is one of the important causes of neonatal morbidity and mortality, accounting up to 30% of neonatal death in Nepal. It is also an important cause of long term neurological disability and impairment. Thompson encephalopathy score is a clinical score which can be used to assess the newborn with hypoxic ischemic encephalopathy for the prognosis and their neurodevelopmental outcome. The aim of the study was to assess the role of Thompson score in predicting the early outcome of neonates with birth asphyxia. Methods: A prospective study was conducted from May 2019 to April 2020 in Nepal Medical College. All the term babies during the period with Apgar score of less than seven at five minutes were considered to have birth asphyxia and included in the study. Neurological examination was done on first, second and third day using HIE score proposed by Thompson and severity of hypoxic ischemic encephalopathy was classified accordingly. Outcome was measured as normal, morbidity with encephalopathy, seizure, organ dysfunction and death. Results: Out of 391 newborn admitted to neonatal unit, 84 (21.4%) had birth asphyxia. Mild Thompson score on day 1,2,3 were 49(58.3%), 49 (58.3%), 51(60.7%); moderate Thompson score on day 1,2,3 were 21 (25%), 21 (25%), 18(21.4%) and severe Thompson score on day 1, 2, 3 were 14 (16.7%), 14 (16.7%), 15(17.9%) respectively. Out of 14 babies who had severe Thompson score on day 1, 11(91.7%) expired and 3 (16.7%) developed encephalopathy. Conclusions: There was strong correlation of severity of Thompson score with the outcome. Keywords: Birth asphyxia; hypoxic ischemic encephalopathy; thompson score

scholarly journals Clinical Patterns of Polyneuropathy Attending in a Tertiary Level of Hospital

2014 ◽  
Vol 15 (1) ◽  
pp. 03-08
Author(s):  
Makhan Lal Paul ◽  
Rezaul Karim Khan ◽  
Md. Zulfiqar Hossain Khan ◽  
Md. Mahabubur Rahman ◽  
Monoj Sinha ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Current Knowledge ◽  
Chronic Inflammatory Demyelinating Polyneuropathy ◽  
Cross Sectional Study ◽  
Muscle Cramp ◽  
Unknown Etiology ◽  
Cross Sectional ◽  
Female Ratio ◽  
Clinical Pattern ◽  
History Of

A cross sectional study was carried out in the department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka to explore the different clinical pattern of polyneuropathy. A total of 60 subjects were included in this study and mean age of the entire patient was 42.25 year and male and female ratio was 3:1. Out of all patients 26.7% were service holder, 20.0% were student, 20.0% were housewife, 11.7% were unemployed and 33.3% were engaged in some other professions. Maximum 41.7% patients were educated up to graduate and above level followed by 20.0% secondary, 18.3% primary, 16.7% higher secondary and 3.3% were illiterate. Out of all patients 31.7% were smoker, 48.3% were non smoker and 20.0% past smoker. About 35.0% patients had history of betel leaf; nut chewing and no patient had history of alcohol intake. Out of all patients of polyneuropathy 33.3% had diabetic neuropathy, 11.7% had Guillain-Barré syndrome (GBS), 10.0% had chronic inflammatory demyelinating polyneuropathy, similar number had unknown etiology, 6.7% had renal failure, 5.0% had leprosy, Vitamin B 12 deficiency and chronic liver disease(CLD) of each, 3.3% had history of INH drug intake and similar had systemic lupus erythematosus (SLE). Regarding clinical presentation, out of all respondents 83.3% had muscle weakness, similar number had problems with object handling, 66.3% had muscle cramp, 63.3% had impaired standing or gait, 55.0% had distal paresthesia, 41.7% had burning feet, 8.3% had restless legs and 5.0% had stiffness. In the light of this study we conclude that polyneuropathy has wide variety of clinical pattern. The study will enrich our current knowledge and will improve the quality of management of polyneuropathy among the Bangladeshi population.DOI: http://dx.doi.org/10.3329/jom.v15i1.19851 J Medicine 2014; 15: 3-8

Outcome of West Syndrome: A Critical Review

2020 ◽  
Vol 09 (01) ◽  
pp. 001-006
Author(s):  
Sudhir Adhikari ◽  
Deepa Gautam
Keyword(s):  
Age At Onset ◽  
Neurodevelopmental Outcome ◽  
Hormonal Treatment ◽  
Severe Disabilities ◽  
Clinical Syndrome ◽  
West Syndrome ◽  
Oral Steroid ◽  
Unknown Etiology ◽  
Sustained Remission

AbstractWest syndrome is a genetically heterogeneous electro-clinical syndrome starting in early infancy. Short-term goal of therapy is spasm control and with standard hormonal or vigabatrin treatment, spasms can be controlled in 60 to 80% of patients in 2 weeks to 3 months period. Hormonal treatment with oral steroid is an alternative therapy to injectable adrenocorticotropin hormone, especially in low resource areas. Vigabatrin is preferred in tuberous sclerosis patients. Long-term aim of treatment is sustained remission of seizures and better neurodevelopmental outcome. About 50 to 70% of children are spasm free for prolonged duration, but epilepsy with multiple seizure types including Lennox–Gastaut syndrome is evident in 20 to 40% of children in long-term follow-up. Though hypsarrhythmia is helpful for the diagnosis, prognostic role of the resolution of electroencephalographic abnormalities is still uncertain. Seizures can be controlled in 40 to 60% of the patients, but only 12 to 40% children have normal neurodevelopmental outcome and a third of children are left with severe disabilities. Children with unknown etiology and normal development at spasm onset have better clinical outcome. Young age at onset, nonstandard therapy have less favorable outcome. Surgery is helpful for spasm control in patients with structural lesions and refractory spasms even in the absence of structural lesions.

scholarly journals Efficacy of antiepileptic drugs in neonatal seizures: a systematic review protocol

2020 ◽  
Vol 4 (1) ◽  
pp. e000683
Author(s):  
Yang He ◽  
Jun Tang ◽  
Meng Zhang ◽  
Tao Xiong ◽  
Shalini Ojha ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antiepileptic Drugs ◽  
Neurodevelopmental Outcome ◽  
Case Series ◽  
Primary Data ◽  
Cochrane Library ◽  
Neonatal Seizures ◽  
Case Control Studies ◽  
Long Term Outcomes

IntroductionSeizures are one of the most common neurological disorders of neonates, which is also an emergency in the neonatal intensive care unit. For neonates, the recommended first-line antiepileptic drugs (AEDs) include phenobarbitone, which may be effective in only 50% of seizures. Some new AEDs, such as levetiracetam, have been shown to be effective in adults and older children. However, their efficacy for neonatal seizures remains uncertain. The aim of this investigation is to conduct a systematic review to evaluate the efficacy of all AEDs in neonates. Additionally, the long-term outcomes following neonatal seizures, in relation to the development of cerebral palsy and epilepsy, will be studied.MethodWe will perform a systematic review including randomised controlled studies (RCTs), cohort studies, case-controlled studies and case series studies which evaluated the efficacy of AEDs and short-term and long-term outcomes in neonatal seizures. PubMed, Embase, Web of Science, Cochrane Library and Clinical trial.gov will be searched. There will be no language restriction. Risk bias in RCTs will be evaluated by the Cochrane risk-of-bias tool, while cohort and case-control studies will be evaluated by the Newcastle-Ottawa Scale. A network meta-analysis will be performed by the Bayesian model using WinBUGS V.1.4.3 and R software if there is a high degree of homogeneity among studies. Otherwise, we will perform a narrative review without pooling. Subgroup analyses will be performed in different AEDs and dosage groups.OutcomeThe primary outcomes will be seizure cessation confirmed by electroencephalogram and long-term neurodevelopmental outcome. Secondary outcomes will be neonatal mortality during hospitalisation and suspected drug toxicity.Ethics and disseminationFormal ethical approval is not required as no primary data are collected. This systematic review will be disseminated through a peer-reviewed publication.

Neuro-imaging findings in children with developmental delay and cerebral palsy: experience from a tertiary medical center of Bangladesh

2021 ◽  
Vol 11 (2) ◽  
pp. 112-115
Author(s):  
Naheed Nabi ◽  
Jannatara Shefa ◽  
Shaheen Akhter
Keyword(s):  
Cerebral Palsy ◽  
Ct Scan ◽  
Developmental Delay ◽  
Medical Center ◽  
Common Finding ◽  
Anatomical Location ◽  
Cross Sectional ◽  
Female Ratio ◽  
Male Predominance ◽  
Neuro Imaging

Background: Cerebral palsy (CP) is the most common developmental disability in children. Neuro-imaging in CP is widely used investigation. Imaging study can visualize the anatomical location of lesion in brain. The aim of this study was to find out the extent of non-progressive damage in brain among children with CP. Methods: This was a cross-sectional study. Data were collected from the out-patient department of Institute of Pediatric Neurodisorders & Autism (IPNA), Bangabandhu Sheikh Mujib Medical University (BSMMU) from December, 2019 to March, 2020. Results: Total 88 cases (age up to 14 years) were reviewed. There was male predominance and male to female ratio was 2:1. Computed tomography (CT) scan was done in majority of patients (71 cases) and magnetic resonance imaging (MRI) in 17 cases. Major abnormalities were atrophy in 34.1% cases, ventricular dilatation in 14.8% cases, encephalomalacia in 19.3% cases and basal ganglia lesion in 11.4% cases. Overall in CT scan group, 95.77% cases were abnormal and in MRI group, 88.23% were abnormal. Conclusion: Atrophy of the brain was the most common finding in neuro-imaging of patients with CP and developmental disabilities. Neuro-imaging is very useful and recommended for the children with developmental delay and CP cases. It may help to classify the CP and may give a clue for further investigations such as metabolic screening and genetic testing. Birdem Med J 2021; 11(2): 112-115

scholarly journals Clinical profile, etiology, type and outcome of neonatal seizures: a hospital-based study

2021 ◽  
Vol 9 (1) ◽  
pp. 104
Author(s):  
Mohmad Saleem Chesti ◽  
Naveed Shahzad ◽  
Shilakha Chaman ◽  
Sheenam Gazala
Keyword(s):  
Birth Asphyxia ◽  
Clinical Profile ◽  
Neonatal Seizure ◽  
Neonatal Seizures ◽  
Medical Sciences ◽  
Long Term Outcomes ◽  
Acute Symptomatic Seizure ◽  
Ethical Clearance ◽  
Common Infections

Background: Our study was undertaken to study the etiological factor, clinical profile, types and outcome of newborn with neonatal seizures (NNS).Methods: Our study was hospital based prospective study was done in Sheri Kashmir institute of medical sciences (SKIMS) Bemina from April 2013 to April 2015 in NICU, after obtaining ethical clearance from institutional ethical committee. All neonates fulfilling inclusion criteria were included in our study.Results: In our study, 80 neonates with seizures were included in our study, among them 48 were males and 32 were females. Majority of neonates (57.5%) developed seizures during first 72 hours of life due to birth asphyxia. Commonest types of neonatal seizures observed in our study were subtle observed in 46 cases, followed by tonic (21.2 %), clonic (14.9 %) and mixed (6.2%) seizures. Birth asphyxia was commonest cause (57.5%) of NNS, sepsis with meningitis (18.7%) followed by hypoglycemia (13.7%) and hypocalcemia (5%). Cases of birth asphyxia were associated with higher mortality (58.3%) as compared to cases with metabolic seizures.Conclusions: From our study we conclude that commonest cause of neonatal seizure was birth asphyxia occurring within 72 hours of birth. Sepsis and meningitis were also common infections resulting in neonatal seizure, while as hypoglycaemia and hypocalcemia were common biochemical abnormalities leading to NNS. Early identification and treatment are likely important for long-term outcomes in acute symptomatic seizure.

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