Definition

[1]
Neonatal seizures are seizures in a child less than 28 days old

Incidence

[2]
80-120 per 100,000 births

Age

<10 days

Gender

More common in males

Aetiology

[3]

Risk Factors

[4]
  • Low Birth Weight
  • Caesarean section
  • Young Maternal Age
  • Family History of Seizures

Signs and Symptoms

[5]

Pathophysiology

[6]
Seizures occur more often in the neonatal period than any other time. In the neonatal period the brain is more excitable and therefore the risk of seizure is much higher, especially if there is an underlying trauma or illness.

Investigations

[7]

Bloods

Serum glucose - assess for hypoglycaemia
Urea and electrolytes - assess for renal impairment and electrolyte disturbance

Other

  • EEG
  • Lumbar Puncture and Cerebrospinal Fluid Analysis
  • TORCH (toxoplasmosis, rubella, CMV, herpes) infection studies - may be positive

Diagnosis

[8]
Diagnosis is made clinically. Aetiology requires further investigation

Differentials to rule out

Treatment

[9]

Non-Pharmacological

  • IV Fluids
  • Correct electrolyte imbalance
  • Stop feeding - if metabolic deficiency suspected

Pharmacological

Management

[10]
Patients should be transferred to a centre with a neonatal ICU. Follow up with a paediatrician/ neonatologist is important and may require ongoing care if seizures persist.

Complications

[11]
  • Intracerebral haemorrhage
  • Neonatal death
  • Psychomotor delay

Prognosis

[12]
Prognosis depends on the aetiology. A seizure with no significant EEG changes has a good prognosis.

See Also

Medscape - Neonatal Seizures
  1. ^ http://emedicine.medscape.com/article/1177069
  2. ^ http://emedicine.medscape.com/article/1177069
  3. ^ http://emedicine.medscape.com/article/1177069
  4. ^ http://www.ncbi.nlm.nih.gov/pubmed/11427400
  5. ^ http://emedicine.medscape.com/article/1177069
  6. ^ http://www.medmerits.com/index.php/article/neonatal_seizures/P5
  7. ^ http://emedicine.medscape.com/article/1177069
  8. ^ http://emedicine.medscape.com/article/1177069
  9. ^ http://emedicine.medscape.com/article/1177069
  10. ^ http://emedicine.medscape.com/article/1177069
  11. ^ http://www.medmerits.com/index.php/article/neonatal_seizures/P9
  12. ^ https://www.health.qld.gov.au/qcg/documents/g_seizure5-0.pdf