NEONATAL SEIZURES: NARRATIVE REVIEW

ABSTRACT

Neonatal seizures are often complex and difcult to recognize, but can be identied through electroencephalogram (EEG) monitoring. The Brighton Collaboration has developed a scheme with ve levels of diagnostic certainty to guide treatment decisions when EEG is not available. Different seizure types are usually associated with specic underlying causes, which may require specic diagnostic and treatment approaches. Neonatal seizures require prompt management, including the stabilization of cardiovascular and respiratory function and the identication of the underlying cause. EEG monitoring is considered essential for the detection of seizures and should be performed until the neonate has been seizure-free for 12 to 24 hours. Treatment involves the use of antiseizure medication and may include pyridoxine challenge or other treatment options such as the ketogenic diet, intravenous immunoglobulin, or corticosteroids if seizures are refractory to conventional antiseizure medication. It is important to differentiate between seizures and nonepileptic motor phenomena, which can occur without obvious cause or as symptoms of drug withdrawal, electrolyte abnormalities, hypoglycemia, or infection. Neuroimaging is also considered essential for the detection of possible structural abnormalities in neonates with seizures.