IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 15, Issue 1 Ver. III (Jan. 2016), PP 15-19 www.iosrjournals.org DOI: 10.9790/0853-15131519 www.iosrjournals.org 15 | Page A Study of Clinico-Etiological Profile of Neonatal Seizure: A Tertiary Care Hospital Based Study Dr. Rameswar Prasad Mishra 1 ; Dr. Abhirup Biswas 2 ; Dr. Anindita Maiti 3 ; Dr. Anumita Maiti 4 1. Assistant Professor ,Paediatric Department,HI-TECH Medical College & Hospital,Bhubaneswar,Odisha 2. Post Graduate Student,Paediatric Department,HI-TECH Medical College & Hospital,Bhubaneswar,Odisha 3. Post Graduate Student,Community Medicine Department, HI-TECH Medical College & Hospital,Bhubaneswar,Odisha 4. Post Graduate Student,Community Medicine Department,IMS &SUM Hospital,Bhubaneswar,Odisha I. Introduction Seizures are the most common and distinct clinical manifestation of neurological dysfunction in the newborn infant. 1 Neonatal seizures are a common neurological problem in neonates with a frequency of 1.5- 14/1000 neonates. 2 The occurrence of neonatal seizures per se has been positively correlated with structural brain damage and its consequent sequels at later stages in life. Historically seizures were divided in following clinicalcategories viz. focal clonic, multifocal clonic, tonic, myoclonic, & subtle seizures. 1 Diverse medical conditions in the newborn can be associated with neonatal seizures. Hypoxia-ischemia is nonetheless traditionally considered the most common cause of neonatal seizures. 1,4 Cerebral infarction and stroke the second most common cause of neonatal seizures occurs in otherwise well term infants, without previous risk factors 5,6 and involves left middle cerebral artery territory and presents with right sided clonic seizures. Intracranial hemorrhage is implicated in 10% to 15% of seizures, and amongst them Intra-ventricular hemorrhage or Periventricular hemorrhagic infarction is the most common Intracranial hemorrhage in preterm infants and constitutes around 45% seizures in preterm. 7,8 Central nervous system infections during intrapartum or postnatal period can be associated with seizures9. Biochemical disturbances occur frequently in neonatal seizures either as an underlying cause or as an associated abnormality. 10,11 Metabolic disturbances could be more commonly transient and rapidly correctable or less commonly inherited as persistent causes. Infants of diabetic mothers, small for gestational age infants, infants with birth asphyxia are at more risk of hypoglycemia. Late onset hypocalcaemia due to use of high phosphate infant formula has been cited as common cause of seizures. 12,13 However commonly hypocalcaemia occurs in infants with trauma, hemolytic disease, asphyxia and IDM and usually coexists with hypoglycemia and hypomagnesemia 14 and presents at 2-3 days of life. Hypomagnesaemia with serum <1.5 mg/dl can occasionally manifest with tetany and seizures at 2-4 weeks of age and has secondary hypocalcaemia associated. Hypophosphatemia may be caused by ingestion of milk formulas containing high amounts of phosphorous, excessive parenteral administration of phosphorus, impaired renal function, and hypoparathyroidism. 15 Hyponatremia as a result of fluid overload renal compromise and SIADH (syndrome of inappropriate ADH secretion) can be a frequent complication of birth asphyxia and could complicate the management of seizures in this condition. 16 II. Method A hospital based prospective observational study was undertaken in the Department of Paediatrics, HI- TECH Medical College & Hospital,Bhubaneswar,Odisha Hospital. Estimation of sample size: Sample size was calculated on the basis of prevalence of neonatal seizures in hospitalised children reported from previous studies of around 4%.The total sample size calculated was around 65, however we decided to take at least 100 patients. After taking an informed written consent from the attendants of babies who were admitted in our neonatology section, a total of 100 consecutive neonates within the age group of 0-28 days presenting with seizures from December 2014 to August 2015 were enrolled in the study. The study was approved by the ethics committee of the institution.