بررسي ميزان ضايعات ايسكميك مغزي و يافته هاي تصوير نگاري مغزي در نوزادان مبتلا به تشنج

Seizures and Cerebral Infarction and the Role of Neuroimaging in the Full-Term Newborns

Background: To determine the occurance of cerebral infarction in full-term newborns who were admitted during a one year period in Mofid children hospital due to seizures and to assess the role of the neuroimaging to elucidate the etiology and the possible risk factors in these patients, this study was performed . Materials and Methods: From December of 2004 to December of 2005, all the term neonates who were admitted due to seizure attacks in their first 3 days of life in the neonatal intensive unit, prospectively studied. They were followed up to 18 months. Results: Of 31 neonates who developed seizures during the study, 5 out of them (16%) had seizures because of cerebral ischemic lesions. There were focal seizures in 3 and generalized in 2 of them. All patients were controlled with Phenobarbital, except one who needed a second anticonvulsant agent (phenytoin). Neurological examinations were normal in all except in one neonate who had mild spasticity in his right extremities. Ultrasonography was abnormal in one, while cranial CT scan showed focal cerebral lesions in all five patients. They occurred mostly in the left side, EEGs were abnormal in 3 and normal in 2 neonates. During their follow up, one pateint developed sever mental and motor disability and another one had mild delay in his developmental milestones. Conclusion: Neonatal cerebral infarction is the second common cause of seizure in full-term infants. The etiology is not acurrately known. Neuroimagings (Brain CT scan or preferably MRI) were the potential diagnostic tool in this study. Thus, we recommend it for those neonates that have seizures with normal APGAR scores and apparently normal neurologic examination without any convincing evidence for its etiology.