Edit concept Question Editor Create issue ticket

Neonatal Seizures

Neonatal Convulsions


Presentation

  • We review neonatal seizures and hypocalcemia and present the case of a 6-day-old male infant who presented to a tertiary pediatric emergency department with seizure-like episodes.[ncbi.nlm.nih.gov]
  • The aim of this review is to discuss the spectrum of neuroimaging findings in full-term newborns presenting with seizures, divided into subgroups with different underlying aetiologies. A standard neonatal MRI protocol is presented.[ncbi.nlm.nih.gov]
  • A previously healthy 14 day-old child started presenting reiterated focal motor seizures (FMS) which evolved to status epilepticus. Exams showed high serum levels of ammonia and no other abnormalities.[ncbi.nlm.nih.gov]
  • Here, the authors report the case of a 2-year-old boy with infantile phosphofructokinase deficiency who presented on the third day of life with intractable seizures.[ncbi.nlm.nih.gov]
  • RESULTS: All patients presented with refractory neonatal seizures on the first day of life after an uncomplicated pregnancy and term delivery.[ncbi.nlm.nih.gov]
Vesicular Rash
  • Nevertheless, in the setting of therapy refractory seizures, excluded infections, and linear vesicular rash, a high index of suspicion is needed. This is the first report of simultaneous corticomedullar involvement as early as the third day of life.[ncbi.nlm.nih.gov]
Myopathy
  • Rarely, phosphofructokinase deficiency manifests in infancy as congenital myopathy and arthrogryposis with fatal outcome.[ncbi.nlm.nih.gov]
Neonatal Hypotonia
  • Neonatal hypotonia, seizures beginning at 5 days, and severe retardation were noted in a girl with normal karyotype and biochemical evidence of impaired adrenal function.[ncbi.nlm.nih.gov]
Infantile-Onset Seizures
  • Most had KCNQ2 mutations, but two families had SCN2A mutations, which are normally associated with a mixed picture of neonatal and infantile onset seizures.[ncbi.nlm.nih.gov]

Workup

  • It is a benign syndrome, but its diagnosis requires a workup to eliminate other potentially more serious epileptic syndromes during this period.[medlink.com]
Multifocal Epileptiform Discharges
  • More multifocal epileptiform discharges in EEG, more abnormal neuroimaging findings, and higher incidence of future developmental delay were noted in the group with later epilepsy.[ncbi.nlm.nih.gov]
Hypsarrhythmia
  • All were born at term and discharged home without seizures or concern of encephalopathy, but developed infantile spasms with hypsarrhythmia (or modified hypsarrhythmia) between the ages of 4 and 6 months.[ncbi.nlm.nih.gov]
Hypouricemia
  • Transient hyperammonemia and transient hypouricemia, uncommon features found in NKH, were detected in one patient. High doses of sodium benzoate and dextromethorphan failed to modify the clinical course.[ncbi.nlm.nih.gov]
White Matter Lesions
  • matter lesions on DWI, particularly around 5 days of life.[ncbi.nlm.nih.gov]
  • The extent of white matter lesion on initial DWI can predict neurocognitive outcome. Copyright 2018 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.[ncbi.nlm.nih.gov]
  • Six out of seven infants with a neonatal MRI had a characteristic MRI pattern, with punctate white matter lesions (PWML), which were no longer visible at the age of 6 months, but led to gliotic scarring visible on MRI at the age of 18 months.[ncbi.nlm.nih.gov]
Liver Biopsy

Treatment

  • The objective of this study was to evaluate the efficacy and safety of lidocaine as second-line treatment of neonatal seizures in infants following benzodiazepine treatment but without previous treatment with phenobarbital.[ncbi.nlm.nih.gov]
  • Our present review is updated on the current literature regarding the use of LEV in neonatal seizures treatment. The available data is analyzed to assess LEV pharmacokinetics, efficacy and tolerability in neonatal crises treatment.[ncbi.nlm.nih.gov]
  • At present, evidence is limited on the treatment of neonatal seizures. In order to establish effective treatment, studies using continuous EEG/aEEG monitoring and long-term follow-up are necessary.[ncbi.nlm.nih.gov]
  • The paucity of evidence-based treatment guidelines, coupled with a rudimentary understanding of disease pathogenesis, has made the current treatment of neonatal seizures empiric and often ineffective, highlighting the need for novel therapies.[ncbi.nlm.nih.gov]
  • Evidence is growing for deleterious effects of seizures on outcomes, elevating the importance of seizure detection and effective treatment.[ncbi.nlm.nih.gov]

Prognosis

  • This KCNQ2 mutation has implications for diagnosis and prognosis of familial neonatal seizures.[ncbi.nlm.nih.gov]
  • An EEG is necessary to recognize the seizures, and interictal tracing may help in assessing prognosis. Ischemic stroke is associated with seizures of early onset, being focal or unilateral.[ncbi.nlm.nih.gov]
  • The evolution of the diagnosis, etiology, management, and prognosis of neonatal seizures over the past two decades is reviewed. Seizures in the neonate are unique and require special classification.[ncbi.nlm.nih.gov]
  • This autosomal dominant disorder has an excellent prognosis, in contrast to most other causes of neonatal convulsions.[ncbi.nlm.nih.gov]
  • Seizures may also result from diverse causes of neonatal encephalopathy, with those in the neonatal period portending a worse neurodevelopmental prognosis if associated with damage to the developing brain.(2) The diagnosis of seizures in the neonatal[ncbi.nlm.nih.gov]

Etiology

  • Prognosis depends on the etiology, seizure type, neurological examination at discharge and EEG. Long term neurodevelopmental follow up is essential for babies with neonatal seizures.[ncbi.nlm.nih.gov]
  • Thorough and timely evaluations of such patients are necessary to identify and treat the underlying etiology, therefore reducing potential morbidity and mortality.[ncbi.nlm.nih.gov]
  • Better understanding of the risk of post-neonatal epilepsy based on etiology is emerging with new epidemiological studies.[ncbi.nlm.nih.gov]
  • EEG is also useful diagnosing the underlying etiology of neonatal seizures. Although conventional EEG is the gold standard for the diagnosis of neonatal seizures, amplitude-integrated EEG (aEEG) can be considered an option.[ncbi.nlm.nih.gov]
  • Inborn metabolic errors (IME) and cortical developmental malformations are uncommon etiologies of neonatal seizures, however they may represent treatable causes of refractory epilepsy and for this reason must be considered as possible etiological factors[ncbi.nlm.nih.gov]

Epidemiology

  • Better understanding of the risk of post-neonatal epilepsy based on etiology is emerging with new epidemiological studies.[ncbi.nlm.nih.gov]
  • In the following article, the authors discuss many issues related to this syndrome, including etiology, pathogenesis and pathophysiology, epidemiology, and differential diagnosis.[medlink.com]
  • Epidemiology The prevalence of neonatal seizures is approximately 1-5%. The overall incidence is 3 per 1,000 live births (57 to 132 per 1,000 live births in pre-term infants) [ 2 ]. Etiology The etiology of neonatal seizures is diverse.[omicsonline.org]
  • EPIDEMIOLOGY- INDIA(NNPD;2002-03)  Incidence : 10.3 per 1000 live births  The incidence is high in PRETERM neonates (2 fold), VLBW( 4 fold) compared to TERM neonates.  Term neonates- 8.4  Preterm neonates-20.8  VLBW-36.1 6.[slideshare.net]
  • .); the Departments of Epidemiology (A.D.S., S.A., Z.W., J.C.G., N.P.) and Statistics and Probability (Z.W., J.C.G.), Michigan State University, East Lansing; and Pharmakon Laboratories, Pittsburgh (B.M.). Address reprint requests to Dr.[nejm.org]
Sex distribution
Age distribution

Pathophysiology

  • Both are expressed in the brain, and although mutations have not been associated with epilepsy, we propose a pathophysiologic mechanism by which the combination of molecular changes may cause seizures. [Indexed for MEDLINE] Free full text[ncbi.nlm.nih.gov]
  • We review the literature, genetics, suspected pathophysiology and possible neonatal manifestation. Incontinentia pigmenti is rare and, therefore, diagnosis is frequently delayed.[ncbi.nlm.nih.gov]
  • Neonatal seizures are classified, based on their presentation as, clinical seizures, electroclinical seizures and electroencephalographic seizures; based on the pathophysiology as epileptic and nonepileptic seizures; and also on the basis of the etiology[ncbi.nlm.nih.gov]
  • EEG with intravenous diazepam was useful to know pathophysiology of infantile spasms.[ncbi.nlm.nih.gov]
  • In the following article, the authors discuss many issues related to this syndrome, including etiology, pathogenesis and pathophysiology, epidemiology, and differential diagnosis.[medlink.com]

Prevention

  • Although many seizures may be prevented by careful attention to metabolic changes and the neonate's overall condition, those that cannot be prevented may require pharmacologic treatment.[ncbi.nlm.nih.gov]
  • First, neonatal seizures themselves require emergency therapy and second, etiology-specific therapy is important in order to prevent further brain injury. At present, evidence is limited on the treatment of neonatal seizures.[ncbi.nlm.nih.gov]
  • Hospital for Sick Children Health A-Z Search a complete list of child health articles expand_more View All Drug A-Z Search a list of articles about medications expand_more View All Learning Hubs Browse a complete list of content groups Healthy Living & Prevention[aboutkidshealth.ca]
  • Because several causes of seizures in newborns require rapid recognition and treatment to prevent further injury, early recognition is important. Seizures in newborns frequently have more subtle clinical manifestations than in older children.[neoreviews.aappublications.org]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!