Common causes, seizure types, and outcomes of neonatal convulsions: insights from Ahmed Gassim hospital for children

Background: Neonatal convulsions are characterized by paroxysmal alterations in neurologic function and can occur from birth until the end of the neonatal period (1-28 days of age). Despite advancements in medical science and global health improvements, neonatal seizures remain common and are associated with significant morbidity and mortality.

Objective: This study aimed to identify the common causes of neonatal convulsions in patients admitted to Ahmed Gassim Hospital for Children between January 2022 and April 2022, and to evaluate the associations between the underlying causes, short-term outcomes, and duration of hospital admission.

Method and Design: This hospital-based study was carried out at Ahmed Gassim Hospital for Children in Khartoum State. Data were collected through a structured interview questionnaire and analyzed using the Statistical Package for the Social Sciences (SPSS). 

Results: The study included 80 neonates, predominantly male (63.75%), with most being term infants (97.5%). Seizures occurred primarily within the first 5 days of life (47.5%), with recurrence in 98.75% of cases. Focal seizures (70%) were more common than generalized seizures (30%), with tonic-clonic seizures being the most frequent type (65%). Seizures were generally brief (<5 minutes in 95% of cases), and most patients (87.5%) were hospitalized for 1-3 weeks. Key diagnoses were hypoxic-ischemic encephalopathy (HIE) (38.75%) and meningitis (33.75%). Poor short-term outcomes were linked to meningitis (p=0.002), while IVH was associated with 100% mortality. Cesarean deliveries had lower rates of good outcomes (16.25%) compared to vaginal deliveries (35%). Overall, good outcomes were observed in 51.25% of cases, while 27.5% experienced complications and the mortality rate was 10%. Significant associations were found between HIE/meningitis and tonic-clonic seizures (p=0.0021) and between neonatal meningitis and poor outcomes (p=0.002).

Conclusions: This study highlights the critical role of underlying conditions like HIE and meningitis in severe neonatal seizures and their high recurrence rates. It emphasizes the importance of early diagnosis, vigilant monitoring, and targeted interventions to improve outcomes. Further research is needed to explore seizure types, underlying conditions, and outcomes to enhance treatment strategies.