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Current perspective on the issue of neonatal seizures


Authors: S. Suroviaková 1;  A. Rivera G. Ramos 1;  P. Bánovčin 1;  S. Mikolajčíková 2
Authors‘ workplace: Klinika detí a dorastu, Jesseniova lekárska fakulta UK a Univerzitná nemocnica, Martin 1;  Neonatologická klinika Jesseniova lekárska fakulta UK a Univerzitná nemocnica, Martin 2
Published in: Čes-slov Neonat 2023; 29 (1): 5-17.
Category: Reviews

Overview

Neonatal seizures are the most common neurological emergency in the neonatal period and can be associated with significant mortality and neurodevelopmental disability. The etiology of neonatal seizures is heterogenous, but the majority are caused by hypoxic-ischemic encephalopathy in term neonates, and cerebrovascular insults such as infarction and hemorrhage in preterm neonates. The seizure type is determined by its predominant clinical features, and they can be divided into motor (automatism, epileptic spasms, myoclonic, clonic, tonic and sequential) and nonmotor (behavioral arrest and autonomic). However, many neonatal seizures present only as electrographic events without clinical signs, especially in premature newborns. Therefore, conventional electroencephalography with simultaneous video monitoring still represents the gold standard for diagnosis the seizures in neonates. Other investigations, such as neuroimaging, laboratory and genetic tests are performed for finding the cause of seizure. Pharmacotherapy of neonatal seizures is empirical. Among anticonvulsants, phenobarbital is still the first-line drug.

Keywords:

neonatal seizures – Electroencephalography – Epilepsy


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