BIOCHEMICAL ABNORMALITIES IN NEONATAL SEIZURES: A CASE-CONTROL STUDY FROM A TERTIARY CARE CENTRE

Abstract

Background: Neonatal seizures represent one of the most common neurological emergencies in newborns, with a frequency of 0.95–3.5 per 1000 live births. Biochemical disturbances including hypoglycaemia, hypocalcaemia, hyponatraemia and hyperbilirubinaemia are important and treatable causes. Early recognition is critical to reduce neurodevelopmental morbidity. Objective: To study and correlate biochemical abnormalities in neonatal seizures in a tertiary care centre using a case-control design. Methods: A prospective case-control study was conducted over 24 months (September 2019 – September 2021) in the NICU of MGM Medical College, Kishanganj. Fifty neonates with seizures (cases) and 50 healthy neonates without seizures (controls) were enrolled. Blood glucose, serum calcium, serum sodium and total serum bilirubin were measured and compared between groups using SPSS v21.0. Results: Male predominance was observed in the case group (58% vs 48%). Mean blood glucose (58.30 ± 25.03 mg/dL vs 72.00 ± 4.14 mg/dL), serum calcium (6.94 ± 0.82 mg/dL vs 8.61 ± 0.42 mg/dL) and serum sodium (124.38 ± 11.83 mEq/L vs 135.40 ± 3.09 mEq/L) were significantly lower in cases, while serum bilirubin (8.48 ± 6.22 mg/dL vs 2.74 ± 0.69 mg/dL) was significantly higher. All differences were statistically significant (p < 0.0001). Conclusion: Biochemical abnormalities—particularly hypocalcaemia, hypoglycaemia, hyponatraemia and hyperbilirubinaemia—are important contributors to neonatal seizures. Prompt biochemical workup of all neonates presenting with seizures is essential for targeted management and improved neurological outcome.