Temporal lobe hemorrhage in the full-term neonate presenting as apneic seizures

We describe a 1-day-old neonate born after 39 weeks of gestation with the unusual presentation of apneic seizures. He manifested apnea during the first 12 hours of life. Prolonged video electroencephalography (EEG) monitoring captured electrographic seizures in the right centro-temporal region, which correlated with the onset and duration of clinical bouts of apnea and oxygen desaturation. The longest event lasted more than 2 minutes, without development of bradycardia. The clinical seizures resolved after administration of phenobarbital with normalization of the EEG several days later. Head ultrasound disclosed an echogenic mass in the right temporal lobe, corroborated as hemorrhage on brain magnetic resonance imaging. This report emphasizes the importance of EEG in the evaluation of full-term neonates with recurrent unexplained apnea.