The neonatal period is the most vulnerable period of life for developing seizures. Neonatal epileptic seizures often constitute a neurological emergency demanding urgent diagnosis and management. Neonatal seizures are paroxysmal, repetitive, and stereotyped events. They are usually clinically subtle. There is no recognizable post-ictal state. Generalized tonic-clonic seizures probably do not occur. There are 5 main types of neonatal seizures: Subtle seizures (50%) Tonic seizures (5%) Clonic seizures (25%) Myoclonic seizures (20%) Non-paroxysmal repetitive behaviors The prevalence of neonatal seizures is approximately 1.5%. The overall incidence is 3 per 1,000 live births (57 to 132 per 1,000 live births in pre-term infants). Eighty percent occur in the first 1 to 2 days to the first week of life. The etiology of neonatal seizures is extensive and diverse. Severe causes predominate. Hypoxic-ischemic encephalopathy is the most common cause (80% of all seizures in the first 2 days of life). Previously common acute metabolic disturbances such as electrolyte and glucose abnormalities are now unusual causes. Prognosis is cause dependent because the main factor that determines outcome is the underlying cause and not the seizures themselves. Despite high mortality (approximately 15%) and morbidity (approximately 30%), one half of neonates with seizures achieve a normal or near-normal state. One third of the survivors develop epilepsy. Neonatal seizures often impose significant difficulties in their differentiation from normal or abnormal behaviors of neonates. As a rule, any suspicious repetitive and stereotyped events should be considered as possible seizures requiring video-electroencephalogram (video-EEG) confirmation. Neonatal syndromes: Despite the high prevalence of neonatal seizures, epileptic syndromes in neonates are rare and infrequent. These are: Benign familial neonatal seizures Benign neonatal seizures (non-familial) Early myoclonic encephalopathy Ohtahara syndrome
Posted on: Fri, 16 Aug 2013 02:16:31 +0000
Trending Topics
Recently Viewed Topics
© 2015