Neonatal seizures and a 2-year neurological outcome.

A study of 57 infants with neonatal seizures admitted to the Special Care Baby Unit of the Jos University Teaching Hospital over a 3-year period showed perinatal asphyxia and hypoglycaemia as the principal aetiologic factors in 47 and 19 per cent of the cases, respectively. Seizures were commoner in preterm infants, and among them outcome was also poorer. As regards aetiological factors, outcome was poorest with perinatal asphyxia; with a mean (SD) mental age of 72.5 (9.1) weeks at a chronological age of 24 months. Outcome in infants with seizures and coma was most favourably predicted by the absence of abnormal neurological signs, and the way the infant was feeding at 7-10 days. All infants who were clinically and neurologically normal and taking more than half their estimated requirements by mouth at 7 days were not handicapped. The overall incidence was 7.5/1000 live births. The mortality (19.3 per cent) was closely related to the aetiology. In view of the fact that the associated adverse perinatal events are largely preventable, improved prenatal and perinatal health care delivery should lead to a decline in the frequency of neonatal seizures.