Background: Seizures are the most frequent sign of neurological dysfunction in the neonatal period. We studied the incidence, clinical types and etiological factors in neonatal seizures and change/s in the epidemiology of neonatal seizures in the last 2 decades by comparing data from a study done 20 years earlier.

Methods: It was a prospective observational cohort study conducted in a tertiary care teaching hospital in north India from November 2016 to October 2017. 7303 neonates were recruited and of these, 66 (0.9%) had clinical seizures at the time of presentation. Complete demographic details, relevant clinical information and investigations were recorded in the pretested Performa and analysed.

Results: The overall incidence of neonatal seizures was 0.9% (66/7303). The incidence of seizures was 0.44% (29/ 6589) among Inborn and 5.1% (37/714) among Out born neonates. Incidence in ELBW, VLBW, LBW and normal birth weight was 2.5%, 4.4%, 0.62% and 0.84% respectively. Male preponderance was observed with a male to female ratio of 1.44:1. Forty-five (68.18%) neonates had seizures in the first 96 hours of life. Out of 142 seizure episodes in 66 neonates, subtle seizure 68 (47.9%) were the most common clinical type followed by focal clonic 27 (19%) and multifocal clonic 27 (19%). Etiological profile revealed perinatal asphyxia in 14 (21.2%), meningitis in 13 (19.7%), hypocalcemia in 12 (18.2%), hypoglycemia in 8 (12.1%), intracranial bleed in 6 (9.1%), hypernatremia in 4 (6.1%) and acute bilirubin encephalopathy in 4 (6.1%). IEM (1.5%) and CNS malformation (1.5%) were observed in 1 patient each. Cause of seizures could not be ascertained in 3 (4.5%) patients.

Conclusions: Perinatal asphyxia and HIE still remains the commonest cause of neonatal seizures despite significant advancements in perinatal and neonatal care although incidence has decreased when compared to the statistics 20 years back. Biochemical abnormalities still are an important and manageable cause of neonatal seizures.

Keywords: Neonatal Seizures; Perinatal Events; HIE; Biochemical.