pediatrics
Neonatal Seizure Disorders
Key Points
Neonatal seizures usually occur in reaction to a systemic or central nervous system event (eg, hypoxia/ischemia, stroke, hemorrhage, infection, metabolic disorder, structural brain abnormality). Neonatal seizures are usually focal and may be difficult to recognize; common manifestations include migratory clonic jerks of extremities, chewing movements, persistent eye deviations or nystagmoid movements, and episodic changes in muscle tone. Electroencephalography is essential for diagnosis; laboratory testing and usually neuroimaging are done to identify the cause. Treatment is directed at the cause. Givephenobarbitalorlevetiracetamif seizures do not stop when the cause is corrected;fosphenytoinandlorazepammay be added for persistent seizures. 