Neonatal seizure

An overview of neonatal seizures, their causes, diagnosis, and management

Neonatal Seizures

A normal CFM trace used in monitoring neonatal brain activity.

Neonatal seizures are a type of seizure that occurs in newborns, typically within the first 28 days of life. These seizures are a common neurological problem in the neonatal period and can be a sign of significant neurological disorders or brain injury.

Causes

Neonatal seizures can be caused by a variety of factors, including:

• Hypoxic-ischemic encephalopathy
• Intracranial hemorrhage
• Infections such as meningitis or encephalitis
• Metabolic disorders like hypoglycemia, hypocalcemia, or hypomagnesemia
• Genetic disorders
• Congenital brain malformations

Types of Neonatal Seizures

Neonatal seizures can be classified into several types based on their clinical presentation:

• Subtle seizures: These are the most common type and may include eye movements, apnea, or autonomic changes.
• Clonic seizures: Characterized by rhythmic jerking movements.
• Tonic seizures: Involve sustained muscle contractions.
• Myoclonic seizures: Sudden, brief muscle jerks.

Diagnosis

The diagnosis of neonatal seizures often involves:

• Clinical observation: Careful monitoring of the newborn for signs of seizure activity.
• Electroencephalography (EEG): A critical tool for diagnosing seizures, as it records the electrical activity of the brain.
• Cerebral function monitoring (CFM): A simplified form of EEG used in neonatal intensive care units, as shown in the image.
• Neuroimaging: Techniques such as ultrasound, CT scan, or MRI to identify structural brain abnormalities.

Management

The management of neonatal seizures includes:

• Treating the underlying cause: Addressing issues such as infection or metabolic imbalance.
• Antiepileptic drugs (AEDs): Medications such as phenobarbital or phenytoin may be used to control seizures.
• Supportive care: Ensuring adequate oxygenation and ventilation, maintaining normal body temperature, and providing nutritional support.

Prognosis

The prognosis for neonates with seizures depends on the underlying cause and the severity of the seizures. Some infants may have a good outcome with normal development, while others may experience long-term neurological impairments.

Related pages

• Seizure
• Epilepsy
• Neonatology
• Pediatric neurology