Etiological Spectrum of Neonatal Seizures in Neonatal Intensive Care Unit in Tertiary Care Hospital

Background: Neonatal seizures rank as one of the most sensitive neurological emergent conditions presenting most often as foreboders of subbing pathologies that need immediate recognition, as well as treatment for prevention of late neurodevelopmental sequelae, particularly in resource-poor settings. Objective: To determine the frequency of the causes of neonatal seizures in neonatal intensive care unit in tertiary care hospital. Study Design: Descriptive cross-sectional study. Duration and Place of Study: The study was conducted from January to May 2025 in the Neonatal Intensive Care Unit, Department of Pediatrics, CMH Abbottabad. Methodology: A total of 110 neonates aged 1 to 28 days presenting with clinical seizure activity were enrolled. Seizure types were classified into subtle, clonic, tonic, and myoclonic based on observable features. Etiological factors including sepsis, hypoxic-ischemic encephalopathy (HIE), hypoglycemia, hypocalcemia, meconium aspiration syndrome (MAS), and polycythemia were investigated using defined clinical and laboratory criteria. Results: The most frequent seizure type was subtle (48.2%). Sepsis was the leading etiology (80.9%), followed by HIE (44.5%), MAS (24.5%), hypocalcemia (22.7%), hypoglycemia (17.3%), and polycythemia (14.5%). A statistically significant association was observed between age group and polycythemia (p=0.002), while other etiologies showed no significant association with clinical variables. Conclusion: Sepsis remains the predominant cause of neonatal seizures, with subtle seizures being the most common type.