clinco-etiological profile and predictors of outcome of neonatal seizures: a prospective observational study from egypt

Background: neonatal seizures are the most prevalent neurological disorders. in egypt, the characteristics and neurodevelopmental outcomes of neonatal seizures have not been sufficiently explored. methods: the present study was conducted on 120 full-term and preterm newborns from october 2016 and october 2020. the adverse outcomes of cerebral palsy, mortality, developmental delay, and/or epilepsy have been considered. the associations between adverse outcomes and 13 variables were analyzed. results: hypoxic-ischemic encephalopathy (hie) (34.2%) was the most common etiology for neonatal seizures, followed by intracranial hemorrhage (25.8%). the predominant seizure type was subtle (57.5%), preceded by clonic seizure (16.7%). moreover, 72 neonates had a normal outcome, 14 (60%) cases had minor functional disabilities, and 27 (22.5%) newborns survived with one or more neurodevelopmental abnormalities (6 cases had cerebral palsy, and 21 newborns had global developmental delay), with a 17.5 % mortality rate. based on the univariate analysis, 10 variables were associated with an unfavorable outcome; nonetheless, only three variables, namely metabolic acidosis, abnormal cranial ultrasonography findings, and the presence of congenital heart disease, were independent predictors as illustrated by multivariate logistics. conclusion: as evidenced by the obtained results, hie and intracranial hemorrhage were the most common causes of neonatal seizures. perinatal insult, prematurity, seizure onset <24 hours, low apgar score at 1 min, myoclonic or mixed seizure, the efficacy of the anticonvulsant therapy, abnormal cranial u/s, metabolic acidosis, abnormal electroencephalography (eeg) pattern, and the presence of congenital heart disease were the most reliable predictors of adverse outcome.