frequency, causes, and findings of brain ct scans of neonatal seizure at besat hospital, hamadan, iran

how to cite this article: eghbalian f, rasuli b, monsef f. frequency, causes, and findings of brain ct scans of neonatal seizure at besat hospital, hamadan, iran. iran j child neurol. 2015 winter;9(1):56-63. abstract objective neonatal seizures are the most common neurological symptoms and often signal an underlying serious neurologic condition. this study determines the frequency of neonatal seizure, predisposing factors, and brain computed tomography (ct) scan findings. materials & methods in a descriptive cross-sectional study, we evaluated all neonates with seizures who had been hospitalized in besat hospital from 2007–2012. all data were gathered with questionnaires and used to compare with statistical tests by spss (ver 16).   results 141 (4.08%) neonates (m:f; 1:2.2) were diagnosed with neonatal seizures. from the total number of 3,452 neonatal hospitalization, 78% of neonates with seizures were less than 10 days old and 60.3% of infants were born from natural vaginal delivery. as the most common cause, hypoxic-ischemic encephalopathy in this study was associated with 31.3% (n=44) of neonatal seizures and with the highest mortality rate (n=6). among admitted neonates with seizures, the overall mortality rate was 12.8% (18 cases). a total of 33.3% of patients (47 cases) had abnormal ct scan reports and 24.8% (35 cases) of patients were not evaluated with a ct scan. hypoxic-ischemic encephalopathy (47%) and local ischemic changes (25.5%) were the most common findings in the ct scans of neonates with seizures. conclusion there was a significant correlation between neonatal seizures and delivery circumstances (p-value < 0.05). therefore, with improvement of obstetric and delivery circumstances, early detection of predisposing factors and other rare conditions, and rapid effective treatment of these contributing factors, the rate of neonatal seizure in this period can be reduced. references scher ms. seizure in the newborn infant: diagnosis, treatment, and outcome. clin perinatal 2005; 24: 735-772. lanska mj, lanska dj, baumann rj, kryscio rj. a population-based study of neonatal seizures in fayette county, kentucky. neurology 1995; 45:724-32. ronen gm, penney s, andrews w. the epidemiology of clinical neonatal seizures in newfoundland: a populationbased study. j pediatr 1999; 134:71-5. saliba rm, annegers jf, waller dk, et al. incidence of neonatal seizures in harris county, texas, 1992-1994. am j epidemiol 1999; 150:763-9. volpe jj. neonatal seizures. in: neurology of the newborn. 5th ed. philadelphia: wb saunders. 2008. p. 203-44. fanaroff aa, martin rj, neonatal. prenatal medicine. 8 th ed. new york: mosby, 2006; 956-976. scher ms, aso k, beggarly me, et al. electrographic seizures in preterm and full-term neonates: clinical correlates, associated brain lesions, and risk for neurologic sequelae. pediatrics 1993; 91:128-34. tekgul h, gauvreau k, soul j, et al. the current etiologic profile and neurodevelopmental outcome of seizures in term newborn infants. pediatrics 2006; 117:1270-80. rogalski li, minokoshi m, silveira dc, cha bh, holmes gl. recurrent neonatal seizures: relationship of pathology to the electroencephalogram and cognition. brain res dev brain res 2001; 129:27-38. cilio mr, sogawa y, cha bh, liu x, huang lt, holmes gl. long-term effects of status epilepticus in the immature brain are specific for age and model. epilepsia 2003; 44:518-28. lynch m, sayin u, bownds j, janumpalli s, sutula t. long-term consequences of early postnatal seizures on hippocampal learning and plasticity. eur j neurosci 2000; 2:2252-64. ni h, jiang yw, bo t, wang jm, wu xr. c-fos, n-methyl-diaspartate receptor 2c, gaba-a-a1 immunoreactivity, seizure latency, and neuronal injury following single or recurrent neonatal seizures in hippocampus of wistar rat. neurosci lett 2005; 380:149-54. bo t, jiang y, cao h, wang j, wu x. long-term effects of seizures in neonatal rats on spatial learning ability and n-methyl-d-aspartate receptor expression in the brain. brain res dev brain res 2004; 152:137-42. cornejo bj, mesches mh, coultrap s, browning md, benke ta. a single episode of neonatal seizures permanently alters glutamatergic synapses. ann neurol 2007; 61:411-26. sanchez rm, dai w, levada re, lippman jj, jensen fe. ampa/kainate receptor-mediated downregulation of gabaergic synaptic transmission by calcineurin after seizures in the developing rat brain. j neurosci 2005; 25:3442-51. huang l, cilio mr, silveira dc, et al. long-term effects of neonatal seizures: a behavioral, electrophysiological, and histological study. brain res dev brain res 1999; 118:99-107. sayin u, sutula tp, stafstrom ce. seizures in the developing brain cause adverse long-term effects on spatial learning and anxiety. epilepsia 2004; 45:1539-48. fanaroff aa, martin rj. neonatal prenatal medicine. 7 th ed. new york: mosby. 2002.p.887-899. bluvstein e, judith b, moshe b, soloman n. current management in child neurology. 2nd ed. lernard maria. 2002. p.123-128. scafer b, bodensteiner jb. radiological findings in development delay. semin pediatr neurol 1998 mar: 37-8. barkovick aj. pediatric neuroimaging. 3rd ed. new york: lippincott, williams & wilkins, 2000: 162-205. volpe a. neurology of the newborn. 4th ed. philadelphia: w.b saunders. 2000. p.172-202. swaiman kf, ashwal s. pediatric neurology. principles and practice. 3rd ed. new york: mosby. 1999.p. 183-188. haaga jr, lanzieri cf. computed tomography and magnetic resonance imaging of the whole body. third ed. new york: mosby, 1994. girard n, raybaud c. neonates with seizures: what to consider, how to image. magnetic resonance imaging clinics of north america 2011 nov;19(4); 685-708. christopher p. hess, a. james barkovich. seizures: emergency neuroimaging. neuroimaging clinics of north america 2010 nov;20(4):619-637. memon s, memon mh. spectrum and immediate outcome of seizures in neonates. jcpsp 2006; 16(11):717-20. denizmen a, filizy y. our cases of seizures in neonatal unit. j pediatr 1997; 6(1):33-6. park w, kim dy, jung cz. clinical study of neonatal seizure. j korean child neurol soc 1998; 6(1):71-82. dehdashtian m, momen aa, ziaei t, moradkhani s. evaluation of seizure etiology in convulsive neonates admitted to imam khomeini and abozar hospitals of ahvaz 2004-2007. jundishapur scientific medial journal 2009;8(2): 163. mirza rm, posti a. evaluation of causes of neonatal seizure in ali asghar and alavi hospital in ardabil city. scientific journal of ardabil university of medical sciences 2000:50-55. kohelet d, shoehart r, lusky a, et al. israel neonatal network, risk factors for neonatal seizures in very low birth weight infants: population-based study. j pediatr 2005sep;16(8):245-251. kumar a, gupta a, talukdar b. clinico-etiological and eeg profile of neonatal seizures. ind j pediatr. 2007; 74(1):33-7. joseph vj. neonatal seizure. in: joseph vj. neurology of the newborn. 5th ed. philadelphia: wb saunders. 2008.p.216- 223. calciolari g, perlman jm, volpe jj. seizures in the neonatal intensive care unit of the 1989s. types, etiologies, timing. clin pediatr (phila)  2000 mar; 27(3): 119-23. mwaniki m, mathenge a, gwer s, et al. neonatal seizure in a rural kenyan district 1 hospital: aetiology, incidence and outcome of hospitalization. bmc medicine 2010; 8(16):18-25. scher ms, painter mj, bergman i, et al. eeg diagnosis of neonatal seizure: clinical correlation and outcome. pediatr neurol 1986; 5:17-24. gabremariam a, gutema y, leurl a, et al. early-onset neonatal seizure: type, risk factors, and short outcome. ann trop pediatr  2006; 26(2); 127-31. taghdiri mm, emdadi m, eghbalian f, tavasoli ar. radioimaging in convulsion neonates based on brain ct without contrast. scientific journal of hamadan university of medical sciences 2005:50-55. ronen gm, penney s, andrews w. the epidemiology of clinical neonatal seizures in newfoundland: a population based study. epilepsia 1995; 36(suppl 4):28. omenea ja, longeb ac, and okoloa aa. seizures in the nigerian neonate: perinatal factors. int j gynaecol obstet 1981;19: 295-299. john rh, charles fl. computed tomography and magnetic resonance imaging the whole body. 3rd ed. new york: mosby. 1994.p. 163-165. stevenson kd, sunshine p. the management of neonatal seizures. semin pediatr neurol 1999; 27: 72-82. koren g, warwicke b, rajchgot r, donn s. intravenous paraldehyde for seizure control in newborn. ann neurol 2002; 36: 108-110. painter m, pippenger g, wasterlain c. phenobarbital and phenytoin in neonatal seizure. j pediatr 2001; 91: 153-160. rennie j, boylan g. neonatal seizure and their treatment. vol 16. new york: lippincott williams & wilkins. 2003.p.177-181.