Download PDF
J Pediatr Intensive Care
DOI: 10.1055/s-0042-1757479
Original Article

Metabolic Abnormalities in Association with Clinical Neonatal Seizures in an Indian Tertiary Care Centre

Authors

  • Ramesh Bhat Y. 

    1   Department of Paediatrics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India

  • Sandeep PD

    1   Department of Paediatrics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
Further Information
Also available at
  Permissions and Reprints
Preview

Abstract

Metabolic disturbances frequently occur in neonatal seizures either as an underlying cause or as an associated abnormality. A prompt recognition of metabolic abnormalities and early therapy are necessary to avoid poor neurological outcome. Neonates with clinical seizures were enrolled in the study. Diagnostic evaluation included complete blood count, sepsis screen, and estimation of blood glucose, serum sodium, calcium and magnesium before instituting any specific treatment. Metabolic abnormalities were considered as isolated when hypoxic ischemic encephalopathy (HIE), sepsis, intracranial hemorrhage, and polycythemia were ruled out. Among 80 newborns with clinical seizures, one metabolic abnormality was detected in 46 (57.5%) newborns. The commonest metabolic abnormality observed was hypoglycemia, noted in 22/80 (27.5%) newborns. Hypocalcemia was the second common abnormality, noted in 10/80 (12.5%) newborns. Isolated metabolic abnormalities were observed in 23.8% (19/80) of newborns with seizures. Associated morbidities with seizures included HIE in 21 (26.3%) and sepsis in 28 (35%). Hypoglycemia was the commonest isolated metabolic abnormality (12.5%). Metabolic abnormalities co-existed with HIE in nine out of 21 neonates and with sepsis in eight out of 28 neonates. Hypoglycemia was the common abnormality associated with both the conditions. Inborn errors of metabolism constituted 8.8% of the cohort studied (7 of 80 patients). A metabolic abnormality was detected in more than 50% neonates with clinical seizures enrolled in our study. Metabolic abnormality also co-exists in neonates with HIE as well as sepsis-related seizures.

Keywords

metabolic abnormality - neonate - seizure - hypoglycemia - hypocalcemia - hypomagnesemia


Publication History

Received: 10 February 2022

Accepted: 26 July 2022

Article published online:
11 October 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany