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Abstract Background: Neonatal seizures are a common symptom in a great number of metabolic disorders, so it is important to entertain the possibility of an IMD in any neonate presenting with seizures early and diagnose it rapidly, allowing the opportunity for effective intervention as there are many effective treatments, which greatly enhance the chance of a better outcome. Objective: To establish the prevalence of inherited metabolic diseases among babies diagnosed with neonatal convulsions at NICU Cairo University, for early detection, better diagnosis and proper management, thus increasing awareness of these diseases as a cause. Methodology: The present study included 24 neonates presenting with seizures admitted at NICU Cairo University hospital during the period of three months from 1st June to 31th August 2009.Full history, thorough examination , selective metabolic screening and basic metabolic investigations for evaluation were done. Results: Detection of a significant rate (16.7%) with inborn error of metabolism. 4 babies had metabolic derangements, Biochemical genetic diagnosis could be formulated in only 2 neonates: Propionic Acidemia, and Urea Cycle Defect. Key words: Metabolism-Inherited- Inborn errors-Neonatal Seizures- Screening |