pediatrics
Neonatal Seizure Disorders
Prognosis for Neonatal Seizure Disorders
Prognosis depends on the etiology: About 50% of neonates with seizures due to hypoxia-ischemia develop normally. Most neonates with seizures due to a transient electrolyte disturbance (eg, hypocalcemia, hyponatremia) do well when seizures resolve after the disturbance is reversed and long-term antiseizure medications are not required. Those with severe intraventricular hemorrhage have a high morbidity rate. For idiopathic seizures or seizures due to malformations, earlier onset is associated with worse neurodevelopmental outcomes. It is suspected, but not proved, that prolonged or frequent neonatal seizures may cause damage beyond that caused by the underlying disorder. There is concern that the metabolic stress of prolonged nerve cell firing during lengthy seizures may cause additional brain damage. When caused by acute injuries to the brain such as hypoxia-ischemia, stroke, or infection, neonates may have a series of seizures, but seizures typically abate after about 3 to 4 days; they may recur months to years later if brain damage has occurred. Seizures due to other conditions may be more persistent during the neonatal period. 