Incidence of Structural Brain Abnormalities in Neonates with Refractory Seizures

Introduction: Neonatal refractory seizures are associated with increased mortality and neurodevelopmental impairments, often linked to structural brain abnormalities. Early neuroimaging is key for identifying these issues and guiding treatment. This study aims to determine the prevalence of structural brain abnormalities in neonates with refractory seizures and assess their short-term outcomes, focusing on seizure control and neurological deficits. Aims: The study aimed to identify structural brain deformities in neonates with refractory seizures and assess their immediate clinical outcomes. Materials and Methods: This cross-sectional study was conducted at the neonatal intensive care unit of a tertiary care teaching hospital over a period of 2 years. Fifty term neonates diagnosed with refractory seizures were recruited. Clinical data, including demographic details, seizure characteristics, and neuroimaging findings, were collected. Statistical analysis was performed using Stata and Python, with categorical variables assessed using the Chi-square test and continuous variables using the t -test/Wilcoxon rank-sum test. Results: The study included 50 neonates with a median (interquartile range) age of 5 days (2, 20), of whom 44% were female. The mean (standard deviation) weight was 2.5 (0.2) kg, with 58% of neonates weighing more than 2.5 kg. Structural brain abnormalities were identified in 32% (95% confidence interval: 18.6%–45.4%) of the neonates, with the most common findings being noncommunicating hydrocephalus and agenesis of the corpus callosum. Conclusions: This study reveals a high prevalence of structural brain abnormalities in neonates with refractory seizures, emphasizing the importance of routine neuroimaging in high-risk cases.