Objective: Neonates, for many reasons, are at particular risk for the development of seizures, which are a strong predictor of later morbidity and mortality in infants.We undertook this study to determine the incidence, etiologic distribution and neonatal seizure type in neonates with hospital admission over a period of 4 years.Materials and Methods: This, a retrospective study of newborns admitted in hospital with a diagnosis of neonatal seizures, was conducted over a 4 year period between March 2001and March 2005.Data were obtained from hospital records were analyzed using the Chi-square test.Results: Of 4541 newborns, admitted to hospital, during the study period, seizures occurred in 110neonates. The incidence of neonatal seizures was 2.4%; the causes of neonatal seizure were Hypoxic-Ischemic Encephalopathy (HIE) - 36.4%, infections -19.1%, metabolic abnormalities - 7.3%, Intra Cranial Hemorrhage (ICH) - 2.7%, structural disorders - 1.8%and in 32.7%of cases, the cause was unknown.Subtle seizures (39.1%) were the most common type of seizures; and the other types were myoclonic (17.3%), clonic (10.0%), Tonic (7.3%), Generalized Tonic Clonic Seizures (GTCS) (12.7%) and in 13.6% of cases the type of seizure was not mentioned. Mortality rate was 13.6%.Conclusion: Health care workers and parents need to be made aware of subtle seizures and the importance of timely and appropriate treatment to decrease any further complications.

Background: The purpose of the current study is to estimate the incidence of epilepsy after neonatal seizure (NS) by reviewing of the latest studies on the relationship between NSs and epilepsy in newborns and also discuss risk factors may contribute to this relationship. Methods: A literature review was performed using the search terms “ neonatal seizure AND epilepsy, ” “ newborns AND epilepsy, ” “ postneonatal epilepsy. ” After exclusion of several studies, which did not meet inclusion criteria, the epilepsy incidence rate was measured by dividing the number of all cases of epilepsy who had a history of NS in selected studies considered with the number of all newborns enrolled to the studies minus the number of cases who lost the follow-ups. Results: By reviewing the literature, 13 studies were found, which completely meet the inclusion criteria and published between 2009 and 2019, of which three were population-based while the remaining studies performed hospital-based. Overall, the population evaluated in these series has been estimated to be 2438 newborns of which 454 died, and 300 missed the follow-ups. The incidence rate for afterward epilepsy in all 1684 subjects with NS was 20%, literally 343 of the NS subjects. Conclusion: The presented review enrolled the most recent studies encompassing enough and extended the time as well as adequate sample size. Epilepsy is considered a common outcome of NS, particularly in those with other neurodevelopmental comorbidities, even if there were always several limits associated with various study designs and condition.

Introduction: Screening of newborns with seizure, who have curable pathologic brain findings, might be able to improve their final outcome by accelerating treatment intervention. The present study aimed to evaluate the brain ultrasonography findings of newborns hospitalized with complaint of seizure.Methods: The present cross-sectional study designed to evaluate brain ultrasonography findings of hospitalized newborns complaining seizure. Neonatal seizure was defined as presence of tonic, clonic, myoclonic, and subtle attacks in 1 - 28 day old newborns.Results: 100 newborns with the mean age of 5.82 ± 6.29 days were evaluated (58% male).Most newborns were in the<10 days age range (76%), term (83%) and with normal birth weight (81%).22 (22%) of the ultrasonography examinations showed a pathologic finding. A correlation was only found between birth age and probability of the presence of a pathologic problem in the brain as the frequency of these problems was significantly higher in pre-term newborns (p=0.023).Conclusion: Based on the findings of the present study, frequency of pathologic findings in neonatal brain ultrasonography was 22%. Hemorrhage (12%) and hydrocephaly (7%) were the most common findings. The only factor correlating with increased probability of positive findings was the newborns being pre-term.

Objective Seizure is the most common signs of nervous system disease in neonates. The first line of treatments in neonatal seizures (after ruling out and emergency treatment of electrolyte imbalance and hypoglycemia) are phenobarbital and phenytoin. We aimed to evaluate drugs that are more effective on neonatal seizure. Materials & Methods Patients admitted to neonatal wards & NICUs (level IIa&IIb) in Qom hospitals (2015-2017), central Iran with presentation of seizure, were enrolled in this clinical trial study. After ruling out electrolyte imbalance and hypoglycemia these neonates were managed by intravenous phenobarbital, then if no response was seen we added intravenous phenytoin and for remaining neonates with refractory seizure we applied oral levetiracetam as add on therapy. The study was registered as code number of IRCT2016051527896N1. Results Initially, 245 neonates were enrolled. According to exclusion criteria, 12 cases were excluded, and phenobarbital was prescribed to the remaining patients. Out of these, 86 patients did not respond, and phenytoin was prescribed for them. Forty two patients who were not responding to phenytoin were finally treated with oral levetiracetam. Finally, 95. 3% of seizures were controlled with oral levetiracetam but 4. 7% were not cured. Conclusion: When the intravenous form of levetiracetam is not available and neonatal seizure does not respond to first line classic drugs, oral levetiracetam as add on therapy maybe effective.

Neurological manifestations of neonatal disorders have various causes, among them neonatal tetanus, albeit rare, is a potentially fatal and preventable disease, which is seen in underdeveloped and developing countries. Although the disease has been eradicated from I.R. Iran, pregnant women immigrating to Iran from neighboring countries, especially from eastern border, may carry a risk of neonatal tetanus to the child due to inadequate tetanus immunization and inappropriate post-delivery care. It is then important to maintain a high index of suspicion for early diagnosis and prompt treatment, when infants present with poor feeding and abnormal behavior.Case presentation here, we report the clinical course of a newborn with neonatal tetanus, who was admitted with complaints of poor feeding and muscle rigidity, more than a decade after eradication of the disorder.

Objectives This randomized clinical trial aims to evaluate and compare phenobarbital and levetiracetam effectiveness and safety in controlling neonatal seizures as first-line therapeutic options. Materials & Methods Neonates with seizure manifestations presenting to the Bahrami Hospital from March 2020 to March 2022 were enrolled in this study. Patients’ data were recorded, including demographic findings, anthropometric measurements, birth characteristics, and laboratory findings. Patients were randomly divided into the phenobarbital and levetiracetam treatment groups. Outcomes defined as adverse effects, response to medication, time to start enteral feeding, and length of hospital stay were compared between the two treatment groups. Results The current study comprises 44 neonates divided into phenobarbital and levetiracetam groups. Seizure control among the two groups was not significantly different, with levetiracetam and phenobarbital groups showing seizure control of 68. 2% and 59. 1%, respectively. Moreover, no significant difference was observed regarding the duration of hospitalization and time to initiate feeding. No adverse effect was reported in either group. Conclusion This study showed no significant difference between levetiracetam and phenobarbital for neonatal seizure control.

Background: Neonatal seizure is a rare neurologic condition. The current study aimed at determining the etiology of neonatal seizure. Methods: The current study evaluated the data of 100 neonates who were hospitalized at neonatal intensive care unit (NICU) during 2015-2017. A pediatric neurologist made the final diagnosis of seizure. Patients’ medical records were used to review neonatal seizure variables. SPSS (version 16) was used to perform the statistical analyses. Results: The current study enrolled 100 newborns (41% female) admitted to the NICU following the first episode of seizure and the body temperature of 36. 8-39. 2° C (mean: 37. 2° C). Of 100 participants, 94 (94%) had acute symptomatic seizure and 6 (6%) were compatible with neonatal epilepsy syndrome criteria. According to the results, the commonest etiologies were the neonatal encephalopathy and hypoxic-ischemic encephalopathy constituting 82% of participants. Conclusion: The consequences of acute symptomatic seizures in neonates are determined mainly by the etiology of the seizures. Seizure burden and use of anti-seizure drugs may also have some impact, but this has yet to be fully defined.