Magnetic resonance imaging for diagnosis and prognosticating neurological outcome in cases of neonatal seizure

Background: Neonatal seizures are one of the leading causes of neonatal mortality and morbidity. In cases of neonatal seizures, the cause of the seizures determines the long-term outcome. There are a number of adverse outcomes associated with this condition, including hearing loss,recurrence of seizures, impaired mental and motor development, and cerebral palsy. The use of magnetic resonance imaging (MRI) of the brain for the diagnosis of neonatal seizures has become one of the most common diagnostic methods since it does not require radiation and is possible to perform during the newborn's physiological sleep. Aim of this study was to examine etiological associations, the long-term neurological consequences, and the use of magnetic resonance imaging as a tool for predicting neurodevelopmental outcomes in newborn infants with seizures. Methods: In this retrospective cohort study, a tertiary care hospital was used as the setting. The study included neonates with seizures who underwent MRI scans of their brains during their hospitalization. A structured clinical follow-up period of 18 to 24 months was used to assess the neurodevelopment of the child. Results: A total of 92 percent of 48 infants who underwent MRIs had an underlying cause. A diagnosis of hypoxic-ischemic encephalopathy was the most common (27%), followed by a diagnosis of meningitis (23.2%).Of the 43 infants who were followed up, 21 were found to have neurodevelopmental impairment (NDI), while ten were found to have moderate to severe neurodevelopmental impairment, with these outcomes being more common in infants without HIE. MRI findings were abnormal in 32 of 48 infants scanned. The absence of major cerebral lesions is highly correlated with a normal neurological outcome. Conclusion: MRI helped identify the etiology of seizures in 92 percent of cases. At 18-24 months, the risk of neurodevelopmental delay is low if the MRI brain shows no lesions. The findings of this study demonstrate the utility of MRI in neonates for diagnosing and predicting neurological outcomes.