Neonatal seizures can be difficult to diagnose because the seizure may be short and subtle. In addition, symptoms of neonatal seizures may mimic normal movements and behaviours seen in healthy babies.
A neonatal seizure is a seizure in a baby younger than 4 weeks old. Seizures are abnormally excessive or synchronous neuronal activity in the brain. They are the most frequent neurological problem in the nursery
TYPE OF SEIZURE— subtle, clonic, tonic or myoclonic
Some clinicians use the term subtle seizures to describe seizures if there is an absence of distinct tonic or clonic movements but presence of abnormal eye movements, stereotyped lip smacking, or apneic events.
Focal tonic seizures are characterized by sustained muscle contraction of muscle groups, and thus often appear as abnormal posturing of a single limb or eye deviation.
A focal tonic seizure can generalize, or the first seizure can occur as a generalized seizure, or seizures that impair the neonate’s level of consciousness.
Generalized tonic seizures typically appear as symmetric and sustained posturing of limbs in either an extensor or flexor distribution
Myoclonic movements can either be caused by seizures or be benign neonatal sleep myoclonus, a common mimicker of seizures in neonates
. These movements typically occur in the limbs or face, and do not repeat. Stimulation can provoke myoclonic seizures.
Symptoms of Subtle Seizures
Subtle seizures are more common among full-term babies. Symptoms of subtle seizures include:
- Random or roving eye movements, eyelid blinking or fluttering, eyes rolling up, eye opening, staring
- Sucking, smacking, chewing and protruding tongue
- Unusual bicycling or pedalling movements of the legs
- Thrashing or struggling movements
- Long pauses in breathing (apnea)
Symptoms of Clonic Seizures
- Rhythmic jerking movements that may involve the muscles of the face, tongue, arms, legs or other regions of the body
Symptoms of Tonic Seizures
- Stiffening or tightening of the muscles
- Turning the head or eyes to one side, or bending or stretching one or more arms or legs
Symptoms of Myoclonic Seizures
- Quick, single jerking motions, involving one arm or leg or the whole body.
- Hypoxic-Ischemic Encephalopathy:
- Intraventricular haemorrhage
- Central Nervous System Infection:
- Inborn Errors of Metabolism:
- hypoglycaemia, Hyponatremia, and hypocalcaemia
- : Neonatal abstinence syndrome
- Anticonvulsant medications –Phenobarbital, lorazepam and phenytoin.
- hypoxic ischemic encephalopathy(not enough oxygen to the brain) may receive hypothermia treatment, which may reduce brain damage caused by the lack of oxygen
- Hypothermic treatment involves cooling the baby’s brain and body by a few degrees immediately after birth for several hours or days. Babies are closely monitored during treatment, and then slowly re-warmed to normal body temperature.