[Neonatal convulsions in health care. I. Incidence, etiology and clinical aspects].

OBJECTIVE

To determine the incidence, etiology and course of neonatal convulsions in the Albacete Health District between 1991 and 1993.

DESIGN

A descriptive study of retrospective cohorts.

SCOPE: 12,427 new born babies in the province of Albacete. The Hospital General de Albacete looks after a population of 376,071 inhabitants, attends 82% of the births in this area and its Neonatology Department is the only one in the province.

METHOD: Incidence: we found 25 new born babies (RN) with neonatal convulsions: absolute incidence (IA) in live RN0/00.; IA in live full-term RN (RNI) 1.4(0/00); IA in preterm RN (RNPT) 13.4(0/00) and in immature RN (with a gestational age of < 29 weeks) 27.8(0/00).

ETIOLOGY: hypoxic-ischaemic encephalopathy 32%, malformations or cerebral dysgenesis 24%, intracranial hemorrhage 16%, with less frequency: infections, metabolic and pharmacological changes 8%, epileptogenic diagnosis 4%.

COURSE: 10 of the RN (40%) died, 8 (32%) had sequelae, although in 3 cases these were transient, and 7 had developed normally (28%). Other relevant aspects are described: neurological findings between crises, type of crisis, EEG and neuroimaging techniques.

DISCUSSION: We attribute the poor prognosis of our series, as compared to other published series, to an increase in the incidence of convulsions associated with a worse prognosis (RN with antepartum fetal distress, cerebral malformations and metabolic encephalopathies), and a decrease in acute intercurrent conditions; hypoglucemia, hipocalcemia and hypothermia, which do not leave sequelae after treatment. Also when methods of clinical inclusion/EEG are used, evaluating only the epileptic phenomena, convulsive crises with minimal clinical signs are observed.