Introduction

Hypoglycemia in newborn is a leading cause of seizures, resulting into a typical pattern of brain injury on MRI with subsequent development of remote symptomatic epilepsy . We retrospectively studied the clinical profile  of children with MRIs showing neonatal hypoglycemic brain injury for  onset ,type of epilepsy and outcome.

Methods

A review was done of 119 children following up in neurology clinic with typical MRI features of neonatal hypoglycemic brain injury and  history of acute neurological symptoms in first week after uneventful birth. Children with history of HIE and congenital anomalies were excluded. Details of clinical presentation, onset and type of epilepsy, drug resistant epilepsy and epileptic encephalopathy were noted .

Results

Total 119 children(93boys and 26girls)  were reviewed . 35/119(29%)were born by LSCS with history of PIH in 23%. 70/119(58%)were low birth weight .94% of children presented with seizures in first week after birth.

Remote symptomatic seizures were present in 89%(107/119) and 43/119(36%) presented before 1 year of age. Focal seizures was most common type. Epileptic encephalopathy, west syndrome was seen  in  35/119(29%) and LGS  in 10/119  . 2 children had history of status epilepticus. Drug resistant epilepsy was noted 42/119(35%) children .Developmental delay was seen (92%) and normal developmental outcome in 8/119 (8%) .

Conclusion

Incidence of remote symptomatic seizures,drug resistant epilepsy,and epileptic encephalopathy is significantly high in children with symptomatic neonatal hypoglycemia and MRI abnormalities . Early identification of at risk neonates can prevent future catastrophic epilepsies and adverse outcome.