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Neonatal cocaine-related seizures
L D Kramer1, G E Locke, A Ogunyemi
1Urban Comprehensive Epilepsy Program of Los Angeles, Institute of Neurological Science, CA.
Insights
Maternal cocaine use during pregnancy can lead to neonatal seizures in infants. These seizures, often presenting shortly after birth, may persist beyond the first month of life.
Area of Science:
- Neurology
- Neonatal Medicine
- Public Health
Background:
- Cocaine abuse is linked to severe acute neurological issues in users.
- Neurologic complications include stroke, hemorrhage, seizures, and death.
Purpose of the Study:
- To report on pediatric patients experiencing seizures attributed to maternal cocaine consumption.
- To describe the clinical presentation and course of these neonatal seizures.
Main Methods:
- Retrospective case series of 16 pediatric patients.
- Evaluation based on neurologic consultation requests.
- Clinical observation and electroencephalographic (EEG) confirmation in some cases.
Main Results:
- All patients presented with postdelivery tremulousness, irritability, and excessive startle responses.
- Stereotypic seizure episodes began shortly after birth.
- EEG confirmed seizures in seven neonates.
- Eight neonates experienced seizures lasting beyond the first month of life.
Conclusions:
- Neonatal seizures are a potential complication of maternal cocaine use.
- Infants exposed to cocaine in utero may exhibit specific neurological symptoms.
- Continued seizures indicate a potentially prolonged neurological impact.
Abstract:
Cocaine abuse is associated with a variety of severe acute neurologic complications typically occurring in the abusers themselves. These include ischemic stroke, subarachnoid and intraparenchymal hemorrhage, headaches, syncope, seizures, and death. Sixteen pediatric patients with presumed cocaine-related seizures secondary to maternal consumption are reported. They were evaluated only because of requests for neurologic consultation. All were seen during the 1987 calendar year at the King/Drew Medical Center and Urban Comprehensive Epilepsy Program of Los Angeles. The cohort had similar maternal pregnancy histories and uniformly presented with postdelivery tremulousness, irritability, and excessive startle responses. Shortly after birth, each patient began having stereotypic episodes with ictal electroencephalographic confirmation in seven. Eight of these neonates continued to have seizures after the initial month of life.