Seizures in the First Week of Life: A Study of Ætiological Factors

Seventy-five consecutive infants who had had seizures in the first week of life, born in one obstetric hospital, are being followed up in a longitudinal study. In this report possible ætiological factors of neonatal convulsions are examined. Infants who had had seizures were compared with a control group to assess obstetric and other factors operating before birth, and were comprehensively investigated to detect metabolic disease, infection and other causes of convulsions. Cerebral hypoxia, usually diagnosed on the basis of foetal distress, was thought to be present in 43 infants. Twenty-nine infants had hypoglycæmia, 27 had hypocalcæmia and six had hypomagnesæmia. Many of the infants with metabolic disturbance had had previous foetal distress. Infection was thought to be the cause in eight infants and cerebral haemorrhage in four. It is concluded that frequently there is a combination of factors—particularly obstetric events predisposing to foetal hypoxia and neonatal metabolic disturbance—leading to neonatal seizures.