[Cerebral seizures in neonatal period: semiology, evolution and factors of influence].

INTRODUCTION

In spite of their incidence being much greater than at any other period during life, seizures occurring during the neonatal period are difficult to identify, since their patterns are not well organized on account of insufficient anatomical, physiological and/or biochemical development.

OBJECTIVE

To analyse the semiology of seizures during the neonatal period, their classification and subsequent evolution.

PATIENTS AND

METHODS

We made a retrospective study of 60 patients who had convulsions during the neonatal period, selected from amongst the children admitted to the Neonatology Department of the Hospital Infantil Universitario Virgen de Rocio in Sevilla, between 1990 and 1998. We investigated 22 medical variables related to the clinical history, neurological examination, neuroimaging studies, EEG and drugs used.

RESULTS

Anomalies were found on the initial examination in 83.3% of the cases. The hypoxic-ischemic syndrome was the commonest etiology, followed by hemorrhages, metabolic disorders, cardiopathies, malformations and infectious diseases. From the semiological angle, the seizures were seen as partial or generalised increase in muscle tone, followed by clonias, hypotonias and subtle seizures. Cerebral angiography was the most commonly used diagnostic imaging technique. There was a statistically significant relationship between the appearance of sequelae and the earliness of the occurrence of the seizures, but not with the duration, semiology or frequency.

CONCLUSIONS

Seizures in the newborn are habitually seen in the hypoxic-ischemic syndrome, and usually present as alterations in muscle tone. Phenobarbitone is still the drug of choice for the treatment of seizures in the neonatal period.