[Neonatal convulsions in health care. I. Incidence, etiology and clinical aspects].

OBJECTIVE

To determine the incidence, etiology and course of neonatal convulsions in the Albacete Health District between 1991 and 1993.

DESIGN

A descriptive study of retrospective cohorts.

SCOPE

12,427 new born babies in the province of Albacete. The Hospital General de Albacete looks after a population of 376,071 inhabitants, attends 82% of the births in this area and its Neonatology Department is the only one in the province.

METHOD

Incidence: we found 25 new born babies (RN) with neonatal convulsions: absolute incidence (IA) in live RN0/00.; IA in live full-term RN (RNI) 1.4(0/00); IA in preterm RN (RNPT) 13.4(0/00) and in immature RN (with a gestational age of < 29 weeks) 27.8(0/00).

ETIOLOGY

hypoxic-ischaemic encephalopathy 32%, malformations or cerebral dysgenesis 24%, intracranial hemorrhage 16%, with less frequency: infections, metabolic and pharmacological changes 8%, epileptogenic diagnosis 4%.

COURSE

10 of the RN (40%) died, 8 (32%) had sequelae, although in 3 cases these were transient, and 7 had developed normally (28%). Other relevant aspects are described: neurological findings between crises, type of crisis, EEG and neuroimaging techniques.

DISCUSSION

We attribute the poor prognosis of our series, as compared to other published series, to an increase in the incidence of convulsions associated with a worse prognosis (RN with antepartum fetal distress, cerebral malformations and metabolic encephalopathies), and a decrease in acute intercurrent conditions; hypoglucemia, hipocalcemia and hypothermia, which do not leave sequelae after treatment. Also when methods of clinical inclusion/EEG are used, evaluating only the epileptic phenomena, convulsive crises with minimal clinical signs are observed.