Premium
Etiology of Convulsions in Neonatal and Infantile Period
Author(s) -
Kurokawa Toru,
Yokota Kiyoshi,
Takashima Sachio,
Nambu Yumiko,
Hanai Toshio,
Goya Nagahide
Publication year - 1976
Publication title -
psychiatry and clinical neurosciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.609
H-Index - 74
eISSN - 1440-1819
pISSN - 1323-1316
DOI - 10.1111/j.1440-1819.1976.tb02274.x
Subject(s) - etiology , medicine , pediatrics , convulsion , epilepsy , psychiatry
SUMMARY1) Etiology of convulsions starting prior to two years of age was discussed in 418 cases. Neonatal seizures before 30 days old appeared in 86 cases (.53 boys and 33 girls). Three hundred and thirty‐two patients (172 boys and 160 girls) had convulsions in infancy. Twelve patients (9 boys and 3 girls) suffered from convulsions both in neonatal and infantile period. 2) Etiology of convulsions was prenatal in 67 cases (16%), natal in 49 cases (12%), postnatal in 158 cases (38%) and unknown in 144 cases (34%). Prenatal factors consisted of cerebral malformation (23 cases, 6%), associated physical minor anomaly such as cataracta or finger anomaly (11 cases, 3%), abnormal perinatal history (8 cases, 2%), congenital heart disease (3 cases, I%), tuberose sclerosis (7 cases, 2%) and positive family history (13 cases, 3%). Postnatal causes included hypocalcemia or hypoglycemia (7 cases, 2%), brain tumors (3 cases, 1%), breath‐holding spells (21 cases, 5%1, febrile convulsion (44 cases, 11%), bathing (3 cases, 1%), afebrile colds (3 cases, l%), purulent meningitis (17 cases, 4%), DPT immunization (10 cases, 2%), vaccination (7 cases, 2%) and acute hemiplegia (10 cases, 2%). The group of unknown etiology were as follows; epilepsy not accompanying interictal neurological signs (38 cases, 9%), epilepsy associated with interictal signs (23 cases, 6%), benign infantile convulsions (57 cases, 14%), neonatal convulsion of unknown etiology (12 cases, 3%) and miscellaneous categories (4%). 3) Pregnancy was abnormal in 53% of cases with cerebral malformation. Asphyxia at birth was noted in 43% of patients with tuberose sclerosis and in 35% of congenital cerebral anomaly. 4) Pneumoencephalographic examinations revealed midline anomaly in 50% of cerebral malformation. It was abnormal in all cases with tuberose sclerosis, head injury and epilepsy with interseizure neurological signs. 5) There were no correlations between the seizure pattern and the etiology in neonatal convulsion. In infancy, focal‐unilateral convulsions and infantile spasms were frequently associated with organic damages. Generalized seizures were seen in organic lesions as well as functional ones although approximately half of the cases were febrile convulsion, benign infantile convulsion or breath‐holding spell. 6) EEG features of cerebral malformation were asymmetrical or multifocal discharges in neonatal period and hypsarhyth‐mia or focal‐unilateral spike discharges in infancy. Tuberose sclerosis showed hypsa‐rhythmia in infancy. In birth injury or cerebral anoxia, EEG mostly revealed focal‐unilateral abnormality or suppression‐burst activity in newborns and hypsarhythmia or focal features in infants. 7) The occurrence rate of neonatal seizures in autopsy cases with intracranial pathology was demonstrated. EEG with intravenous diazepam was useful to know pathophysiology of infantile spasms.