Neonatal Seizures: Postgraduate Dept of Pediatrics
Neonatal Seizures: Postgraduate Dept of Pediatrics
Neonatal Seizures: Postgraduate Dept of Pediatrics
SEIZURES
Postgraduate
Dept of pediatrics
OBJECTIVES
To familiarize the varied presentations of
neonatal seizures.
To distinguish non seizure states from seizures.
DEFINITION OF SEIZURE
TYPES OF NEONATAL SEIZURES
SEIZURE MIMICS
HIE
( most common )
IVH
Acute
metabolic disorder
hypocalcemia
hypoglycemia
hypomagnesemia
hypo/ hypernatremia
Drugwithdrawl maternal drug use of
narcotics or barbiturates.
Drug withdrawal
Kernicterus, hyperbilirubinemia
Infection
Head injury subdural hematoma
Hypoglycemia
Seizures persist
Administer phenobarbitone 20mg/kg IV stat
over 20 minutes
Seizures
continue
Repeat phenobarbitone in 10 mg/kg/dose
aliquots until 40 mg/kg dose is reached
Seizures continue
Seizures controlled
Normal Abnormal
Evaluate EEG
Taper drugs Abnormal EEG
Normal EEG Continue drug;
over 2 weeks Taper drugs over reassess at 3
2 weeks
PROGNOSIS
Focal clonic seizures carry the best prognosis.
Myoclonic seizures carry the worst prognosis in
Hypocalcemia
Early-onset 50%
Later-onset 100%
Hypoglycemia 50%
Bacterial meningitis 50%
SUMMARY
Seizures are common in neonatal period than any
other period of life.
Subtle seizures are the most common type of
neonatal seizures.
Hypoxic ischemic encephalopathy is the most
common cause of neonatal seizures.
Phenobarbitone is the drug of choice for neonatal
seizures.
Focal clonic seizures and seizures due to
subarachnoid hemorrhage and late onset
hypocalcemia carries best prognosis.
REFERENCES
AIIMS NICU PROTOCOL
PGEI NICU PROTOCOL