Sabzehei Mohammad Kazem, Basiri Behnaz, Bazmamoun Hassan
Neonatologist, Department of Pediatrics, Besat Hospital, Hamadan University of Medical Sciences, Hamadan, Iran.
Iran J Child Neurol. 2014 Spring;8(2):24-8.
Seizures in neonates are very different from those of older children and adults. The aim of this study was to determine the etiology, clinical presentation, and outcome of seizures in hospitalized neonates of Besat Hospital, Hamadan, Iran.
MATERIAL & METHODS: In this retrospective study, we evaluated all neonates with seizures (aged 0-28 days) admitted to the Besat hospital, Hamadan, over a period of three years from September 2008 to September 2011. The data were obtained from hospital records and analyzed using SPSS 12.
Seizures were reported in 102/1112 (9.1%) neonatal admissions. Among neonates with seizures, 57% were male and 23.5% were preterm. The mean birth weight was 2936±677 grams and the mean gestational age was 37.60±1.94 weeks. 16.7% of them were LBW and 2.9% VLBW. In terms of seizure type, subtle seizures were observed in 38.2%, tonic in 29.4%, clonic in 26.4%, and myoclonic in 5.9% of cases. The main diagnosis in neonates with seizures included hypoxic-ischemic encephalopathy (HIE) (34.3%), infections (24.4%), intracranial hemorrhage (6.9%), hypoglycemia (5.9%), hypocalcemia (2.9%), inborn error of metabolism (1%), and unknown cause (24.5%). The mortality rate was 14.7%.
Neonatal seizures indicate a significant underlying disease. HIE was the most common cause of neonatal seizures in our study. Therefore, efforts should be made to improve care during childbirth.
新生儿癫痫与大龄儿童及成人的癫痫有很大不同。本研究旨在确定伊朗哈马丹贝萨特医院住院新生儿癫痫的病因、临床表现及预后。
在这项回顾性研究中,我们评估了2008年9月至2011年9月期间入住哈马丹贝萨特医院的所有癫痫新生儿(年龄0 - 28天)。数据从医院记录中获取,并使用SPSS 12进行分析。
1112例新生儿入院病例中有102例(9.1%)报告有癫痫发作。癫痫新生儿中,57%为男性,23.5%为早产儿。平均出生体重为2936±677克,平均孕周为37.60±1.94周。其中16.7%为低体重儿,2.9%为极低体重儿。在癫痫发作类型方面,38.2%的病例观察到细微发作,29.4%为强直发作,26.4%为阵挛发作,5.9%为肌阵挛发作。癫痫新生儿的主要诊断包括缺氧缺血性脑病(HIE)(34.3%)、感染(24.4%)、颅内出血(6.9%)、低血糖(5.9%)、低钙血症(2.9%)、先天性代谢缺陷(1%)以及病因不明(24.5%)。死亡率为14.7%。
新生儿癫痫提示存在重大潜在疾病。在我们的研究中,HIE是新生儿癫痫最常见的病因。因此,应努力改善分娩期间的护理。