An Assessment of the Relationship of Clinico-Etiological Profile with Electroencephalogram and Neuroimaging in Neonates with Seizures Admitted to Besat Hospital in Hamadan: A seven-year experience

Objective: Seizures are one of the most common neurological symptoms in neonates that need to be scrutinized carefully. Limited studies have assessed monitoring of neonatal seizures with electroencephalography and neuroimaging. The present study aimed to assess the relationship of etiologic factors and clinical symptoms with electroencephalogram (EEG) and neuroimaging in neonates with seizures admitted to Besat Hospital in Hamadan.
Methods: This was a descriptive, cross-sectional retrospective study. All neonates with seizures admitted to the NICU of Besat Hospital in Hamadan in 2012-2018 were examined in this study. Demographic data, clinical symptoms, biochemical tests, EEG and brain magnetic resonance imaging (MRI) were extracted from the medical records. Collected data was analyzed using SPSS v. 16. Significance level was 0.05
Results: Of 176 studied infants, 99 (56.3%) were males. Mean gestational age and weight at admission were respectively as 37.9±1.18 and 2197.15±436.73. The most common causes and types of seizures were asphyxia (25.6%) and clonic (35.8%). EEG showed abnormal waves in 37% of neonates. A significant relationship was found between asphyxia, low 1-minute Apgar score, hypoglycemia, recurrence of seizures, the need for more than one drug to control seizures, and abnormal EEG (p<0.001). Abnormal MRI findings were found in 72.2% of neonates with seizures. Abnormal EEG findings were associated with stroke (54.5%), asphyxia (52.9%), and intracranial hemorrhage (44.4%) in MRI findings.
Conclusion: The most common causes of seizures in full-term and preterm neonates were respectively asphyxia and meningitis in this study. The results also showed abnormal EEG in more than one third of neonates with seizures. Most abnormal EEG belonged to asphyxia-inducing and intracranial hemorrhage-inducing seizures. EEG was normal in two-thirds of infants with abnormal MRI. Only half of neonatal seizures responded to phenobarbital as the first-line antiepileptic drug. (NCI-2020-0183.R1)