Neonatal seizures and syndromes

Area of Science:

• Neurology
• Neonatal Medicine
• Clinical Neurophysiology

Background:

• Neonatal seizures are a common complication of neonatal encephalopathies.
• They occur in 1.8-5/1,000 live births and stem from diverse conditions impacting brain function.
• A significant challenge is that seizures may not always present with obvious clinical or electroencephalogram (EEG) abnormalities.

Purpose of the Study:

• To provide a classification of neonatal seizures.
• To highlight the diagnostic difficulties, including non-convulsive seizures and those masked by treatment.
• To review specific neonatal epileptic syndromes.

Main Methods:

• Literature review focusing on neonatal seizures and encephalopathies.
• Analysis of seizure presentation, including clinical and EEG characteristics.
• Discussion of underlying etiologies, including genetic channelopathies and specific epileptic syndromes.

Main Results:

• Many abnormal behaviors in neonates lack ictal EEG patterns.
• Up to 50% of neonatal seizures may not present with abnormal clinical behavior, particularly after anticonvulsant therapy.
• Genetic disorders, such as potassium channelopathies, can cause benign familial seizures.

Conclusions:

• Neonatal seizures are complex and can be challenging to diagnose due to subtle or absent clinical and EEG manifestations.
• Understanding the diverse causes, including genetic factors and specific syndromes like Ohtahara syndrome, is crucial for effective management.
• Further research is needed to improve the detection and treatment of neonatal seizures, especially subclinical events.