Yenidogan Konvulziyonlarinin Etyolojisi ve Tedavi Uygulamalari/Etiology of Neonatal Convulsions and Anticonvulsant Drugs

Citation metadata

Authors: Duygu Besnili Acar, Ali Bulbul, Sinan Uslu, Ilkay Ozmeral Odabasi and Bulent Guzel
Date: Apr. 2019
From: Journal of Academic Research in Medicine(Vol. 9, Issue 1)
Publisher: AVES
Document Type: Report
Length: 3,168 words

Main content

Abstract :

Amaç: Yenidogan döneminde saptanan konvülziyonlarda etyolojik degerlendirme, konvülziyon tipi ve uygulanan antikonvülzan tedavilerinin etkinliklerinin karsilastirilmasi amaçlandi. Yöntemler: Aralik 2010- Ocak 2015 tarihleri arasinda 3. düzey yenidogan yogun bakim ünitesine konvülziyon tanisiyla yatan hastalarin dosyalari retrospektif olarak incelendi. Hastalarin verileri çalisma formuna kaydedildi. Elde edilen veriler term ve preterm bebek alt gruplarinda karsilastirildi. Istatistiksel olarak tanimlayici analiz, Pearson Ki kare ve independent t testleri kullanildi. Bulgular: Belirlenen tarihler arasinda 3. düzey yenidogan yogun bakim ünitemizde yatan 1322 bebegin 41'i konvülziyon tanisiyla izlenmisti. Bebeklerin %63,4'ü erkek, %80'i termdi. Ortalama dogum agirligi 3066[+ or -] g, ortalama dogum haftasi 37,9[+ or -] hafta saptandi. En sik saptanan etyolojik nedenler %14,6 hipoglisemi, %12,2 hipoksik iskemik ensefalopati ve %12,2 hipokalsemi idi. Konvülziyon tipleri %29,3 tanimlanmamis (subtle) tip, %26,8 fokal tonik, %19,5 miyoklonik, %19,5 otonomik ve %17,1 fokal klonik olarak saptandi. Tedavide ilk seçenek antikonvülzan olarak %82,6 fenobarbital kullanilmisti. %30 bebege ikinci antikonvülzan gereksinimi oldugu ve ikinci antikonvülzan olarak en sik (%71,4) fenitoin kullanidigi belirlendi. Preterm ve term bebeklerin verileri karsilastirildiginda; konvülziyon etyolojisi, tipi, sayisi, konvülziyon geçirdigi gün ve aldigi antiepileptik tedavileri açisindan fark saptanmadi. Preterm bebeklerde, term bebeklerden farkli olarak ikinci bir antiepileptik tedavi gereksiniminin olmadigi gözlendi. Sonuç: Sonuç olarak çalismamizda yenidogan konvülziyon nedenleri arasinda en sik hipoglisemi, hipoksik iskemik ensefalopati ve hipokalsemi oldugu, bebeklerin yaklasik yarisinda antikonvülzan tedavi gereksinimi olmadigi, antikonvülzan gereksinimi olanlarda büyük oranda ilk ilaç olarak fenobarbital kullanildigi ve preterm bebeklerde ikinci bir antikonvülzan ilaca gereksinim olmadigi saptandi. Anahtar kelimeler: Yenidogan, konvülziyon, antikonvülzan ilaç Objective: The aim of our study was to evaluate the etiology and type of seizures in newborns, and to compare the efficacy of various anticonvulsant drugs. Methods: Patients hospitalized at the Level 3 neonatal intensive care unit between December 2010 and January 2015 and diagnosed with seizures were included in the study. Obtained data were compared with regard to the term and preterm subgroups. Definition analysis, Pearson's chi-squared test, and independent t-test were used as statistical methods. Results: Forty-one out of 1322 patients hospitalized at the Level 3 neonatal intensive care unit were diagnosed with seizures. Considering gender, 63.4% were male, and 80% of the patients were full term. The mean birthweight was 3066 grams, and the average delivery was at 37.9 weeks. The most common etiologic factors were hypoglycemia (14.6%), hypoxic ischemic encephalopathy (12.2%), and hypocalcemia (12.2%). Convulsion types were the following: unclassified type (29.3%), focal tonic (26.8%), myoclonic (19.5%), autonomic (19.5%), and focal clonic (17.1%). Phenobarbital was used as a first-choice drug in 82.6% of patients. A secondary anticonvulsant drug was required in 30% patients, and phenytoin was used in 71.4% patients. Comparing the data of the full term and preterm subgroups, the seizure etiology, type of convulsion, convulsion time, and medications used to control the seizure were not different. However, preterm patients did not require a secondary antiepileptic drug, as opposed to term patients. Conclusion: Our study demonstrated that the most common disorders that cause seizures in newborns are hypoglycemia, hypoxic ischemic encephalopathy, and hypocalcemia, and one half of the patients did not require any anticonvulsant drug. When a secondary drug was required, it was usually phenobarbital. Preterm newborns usually did not require secondary drugs. Keywords: Newborn, convulsion, anticonvulsant drug ORCID IDs of the authors: D.B.A. 0000-0002-3623-2618; A.B. 0000-0002-3510-3056; S.U. 0000-0002-2004-0419; I.Ö.O. 0000-0002-7717-4426; B.G. 0000-0002-8485-5422.

Source Citation

Source Citation
Acar, Duygu Besnili, et al. "Yenidogan Konvulziyonlarinin Etyolojisi ve Tedavi Uygulamalari/Etiology of Neonatal Convulsions and Anticonvulsant Drugs." Journal of Academic Research in Medicine, vol. 9, no. 1, 2019, p. 1+. Accessed 8 Mar. 2021.
  

Gale Document Number: GALE|A581866413