Lumbar Puncture findings in cases of neonatal seizures in Sulaimani/Kurdistan Region/Iraq

Volume 16 , Issue 1 , July 2026

Authors

Shwan Kanaan Al Singawi 1 ; [email protected] 2

1 University of Sulaimani, College of Medicine, Branch of Clinical Sciences, Kurdistan Region, Iraq

2 University Of Sulaimani, College of Medicine

DOI logo 10.17656/jsmc.10523

Keywords

Abstract

Abstract Background: Neonatal seizures are a medical emergency with diverse etiologies, and cerebrospinal fluid (CSF) analysis by lumbar puncture (LP) may help identify infectious and noninfectious causes and guide management. Objectives: To assess LP findings in neonates with seizures in Sulaimani, Kurdistan Region, Iraq, and examine their associations with etiology, treatment, and outcomes. Materials and Methods: This retrospective observational study included 47 neonates aged 0–28 days with seizures admitted to Dr. Jamal A. Rashid Pediatric Teaching Hospital, Sulaimani, between January 1, 2022 and January 1, 2024, who underwent LP and had complete records. Demographic, clinical, laboratory, CSF, microbiological, treatment, and outcome data were analyzed using SPSS v28. Results: Males comprised 61.7% of cases; 87.2% were term neonates. The most common etiologies were hypoxic-ischemic encephalopathy (36.2%), sepsis (23.4%), hypocalcemia (21.3%), and pyogenic meningitis (10.6%). Mean CSF WBC, protein, and glucose were 24.83±39.47 cells/µL, 144.96±71.54 mg/dL, and 41.60±15.57 mg/dL, respectively. CSF was clear in 61.7%, xanthochromic in 23.4%, cloudy in 8.5%, and bloody in 6.4%. Culture was positive in 10.6% and Gram stain in 8.5%. Pyogenic meningitis showed the highest CSF WBC (135.00±11.18 cells/µL) and protein (313.00±12.04 mg/dL), and lowest glucose (15.20±2.39 mg/dL) (all p<0.001). Neurological sequelae occurred in 8.5% and were associated with higher CSF WBC (70.93±70.91 vs 15.42±29.15; p=0.002), higher protein (206.20±113.66 vs 133.16±60.42; p=0.046), and positive culture (50.0% vs 4.7%; p=0.026). Conclusions: LP provided important diagnostic and prognostic information in neonatal seizures. Marked CSF pleocytosis, elevated protein, low glucose, and positive culture strongly indicated bacterial meningitis and were associated

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