The role of cranial ultrasonography in the diagnosis of neonatal convulsions

Seizures are a major symptom of many neonatal neurologicaldisorders. So, it must deal with it as it affects the mental and neurologicaldevelopment in newborn.The incidence of neonatal convulsions varies from 1.5% [0 14% andthe diagnosis depends mainly on clinical manifestations and theinvestigations. There are many types of neonatal seizures, subtle,generalized tonic, multifocal clonic, focal clonic and myoclonic.Our work included 30 convulsing neonates admitted to neonatal careunit in Zagazig University Hospital between period of November 2004and October 2005, the following data were obtained:(1)23 cases were male and 7 cases were female.(2)9 cases were premarures and the remainder 21 cases were full-termnewborn; 60% were appropriate for gestational age, 23.3% were LBWand 16.6% were VLBW.(3)Different risk factors were encountered among the studied cases,obstructed and traumatic labor seems to be the most important riskfactor, followed by premature rupture of membrane.(4)Early onset seizures (first :2 days of life) were strongly related to GAwith statistical significance (p < 0.01). Early seizures were mostcommon when GA was < 30 or> 36 weeks compared to newborn 3036weeks in whom no predilection was observed to postnatal age.(5)The most common type of neonatal seizure was clonic seizuresv(43.3%) followed by tonic seizures (23.3%), jitterness (20%), subtleseizures (13.3%) and no myoclonic seizures.Summary and conclusion 94(6)Cranial ultrasonography, CT, EbG and laboratory data includingV’electrolytes and CSF analysis play an important role in diagnosis ofneonatal convulsions.(7)Cranial ultrasound is more sensitive than CT in detecting hypoxic./ischemic encephalopathy, while CT is superior in detectingsubarachnoid and subdural hemorrhage and both investigator toolsshow the same sensitivity in detecting other type of hemorrhage, CNSinfection and congenital brain anomalies.