Pattern of neonatal seizures in Osogbo, south-western Nigeria

Abstract

Objectives. A study to determine the pattern and outcome of neonatal seizures. Design. A prospective descriptive study. Setting. Special Care Baby Unit, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria. Subjects. All newborn infants with observed seizures admitted between January 2006 and December 2008. Results. Of 866 neonates admitted, 59 (6.8%) had seizures; of these 43 (72.9%) had been born outside our health facility (outborn). Babies with seizures had a higher birth weight than babies without seizures (p=0.008), and the incidence of seizures had a linear relationship increasing with the weights of the babies and inverse to their ages. Of the 59 babies with seizures, 37 (62.7%) were considered to have had birth asphyxia. Meningitis, hypoglycaemia, and hypocalcaemia occurred in 7 (11.9%), 6 (10.2%) and 2 (3.4%) of cases, respectively, and 7 (11.9%) had undiagnosed causes. Forty-two (71.2%) of the 59 babies had both subtle and generalised seizures. Twenty-seven babies with seizures died (45.8%) compared with 131 of 807 babies without seizures (16.2%, p=0.0001). Babies with seizures and asphyxia or who had been outborn had the highest risk of death (59.5% and 48.8%, respectively). Recommendations. The major causes of neonatal seizures and death are potentially preventable. Comprehensive and vigorous efforts are needed to achieve safe delivery, prevent birth asphyxia and improve care and transport of sick neonates at the primary care level. In view of the high prevalence of seizures among severely asphyxiated neonates and those with meningitis, anticonvulsant chemoprophylaxis is recommended in these groups.