Neonatal seizures occur in babies soon after birth. As many as 1.5 to 2.5 per cent of newborns have seizures in the first month of life. A further 20 per cent of all seizures in children under three years of age are neonatal seizures.
Neonatal disorders are generally classified as subtle, clonic, tonic, and myoclonic.
Subtle attacks are characterized by apneas with cyanosis or hypertonia, episodes of pallor, fixed staring, conjugate eye deviation, finger movements, paroxysmal eye blinking, nystagmus, vasomotor changes, episodic chewing movements, or stereotypic limb movements such as swimming or bicycling motions. Drooling and unusual alertness may accompany neonatal seizures.
While these abnormal behavioural patterns in infants correspond to their seizure types, not all such clinical events are consistently related to EEG discharges. This means not all cases are epileptic in origin.
Neonatal seizures can have many causes, including various metabolic problems, brain damage, or a lack of oxygen during the prenatal period. Cerebral dysmorphism, prenatal infection and vascular occlusion, maternal drug abuse, and a family history of epilepsy can complicate the newborn’s health and may increase the risk of seizures. Furthermore, the seizures themselves may impede brain growth, resulting in cerebral palsy, mental retardation, or epilepsy at a later time.
Benzodiazapines, phenobarbital, and phenytoin may be used to control neonatal seizures. Phenobarbital remains the drug of choice.
