5day old male came to my opd. LSCS delivered for foetal distress in Govt hospital . Cried at birthday but lethargic. Developed subtle seizures on 2nd day. Not controlled by phenobarb load and maintenance at hospital. Referred out. Sepsis screen -ve, RBS and calcium normal. Peculiar wrinkled, dry skin .poor feeding. Shrill cry. Poorly sucking. Poor tone. Mother has a healthy 5yr old daughter. Suggest D/D

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baby developed seizures on d2 tells u it's not hypoxic.u did ruled out common metabolic causes and sepsis.clinical menifestation of lethargy ,shrill cry hypotpnia suggest metabolic encephalopathy. ideally go for abg and Sr ammonia. c did primary investigation u will get idea of further approach.

1 metabolic disturbances as cause of seizures which are common in children born after foetal distress 2.Birth asphyxia 3 cerebral palsy

Causes of convulsion on 2nd day of life... 1- HIE stage 2... generally seizure occur within 12-24 hr of life and persists for 2-10 days.. but we may not know, there can be electrographic seizure in day one of life... so we should enquire about 1st day events and activity 2)- sepsis with meningitis, so we should do sepsis screen and blood culture 3)- Hypoglycemia.. baby seems to be premature, so hypoglycemia is a possibility 4)- Hypocalcemia.. generally calcium reaches nadir on day 2 of life, so electrolytes should be sent 5)- metabolic disorders... So initial screen should be serum ammonia, arterial blood gas 6)- structural malformation of brain.. so cranial ultrasound 7- Intracranial haemorrhage 8)- genetic disorders leading to convulsion like ohtahara syndrome

rule out neonatal sepsis,counts,CPR, L.P.,t/f usg, child seems to be dehydrated,start iv fluid,antibiotics to cover bbb ,do metabolic screening,add one more act to control convulsion,

Intrauterine asphyxia lead to birthasphyxia....Hypoxic ischemic encephalopathy........with cerebral edema ... usually cerebral edema worsens after 12 hours in HIE... on pheno and phenytoin effect its drowsy......dehydration because of poor feeds or improper fluid management.....RFT,electrolites ,sugar ... fluid bolus .. warmth ..sepsis management... will do wonder...

Symptoms suggest a metabolic disorder. Adv. 1. Investigations to exclude IEM

lbw baby with hypoglycaemia &hypothyroidism

Abg and metabolic screen did it. Metabolic encephalopathy and B6 dependant seizure. Neurologist started pyridoxine and bingo.skin improved and seizures stopped. Thanx all

a case of birthaxphyia likely to have cerebral palsy . hypoglycemia & electrolyte to be corrected .

Hydration should been maintained. Rest electrolytes. And was baby hypoxic or not. What was apgar score at time of birth?

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