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How Early Can a Seizure Happen? Pathophysiological Considerations of Extremely Premature Infant Brain Development

Melisa Carrasco1, Carl E Stafstrom2

  • 1Division of Pediatric Neurology, Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Developmental Neuroscience
|April 5, 2019
PubMed

Insights

Neonatal seizures are a neurologic emergency. This review explores seizure pathophysiology in extremely preterm infants, linking clinical features to brain development.

Area of Science:

  • Neonatal neurology
  • Developmental neuroscience
  • Pediatric epilepsy

Background:

  • Neonatal seizures are a critical neurologic emergency requiring prompt diagnosis and treatment.
  • Identifying neonatal seizures is challenging due to unique brain development and varying clinical presentations in premature infants.
  • Seizure pathophysiology in extremely premature infants (< 28 weeks gestational age) remains underexplored.

Purpose of the Study:

  • To review the physiological and structural brain development in extremely premature infants.
  • To identify factors contributing to seizures and their consequences in this population.
  • To hypothesize how brain development influences seizure presentation in extremely preterm infants.

Main Methods:

  • Literature review focusing on brain development in premature infants.
  • Analysis of factors influencing seizure occurrence and characteristics.
  • Synthesis of existing knowledge on neonatal neurology and developmental neuroscience.

Main Results:

  • Extremely premature infants exhibit unique brain development trajectories.
  • Specific developmental factors may predispose these infants to seizures.
  • Clinical and electrographic seizure features are hypothesized to correlate with developmental stages.

Conclusions:

  • The phenomenology of seizures in extremely preterm infants likely reflects their specific developmental pathophysiology.
  • Further research is needed to elucidate the precise mechanisms.
  • Understanding these mechanisms is crucial for accurate diagnosis and effective treatment.

Keywords:
Brain developmentElectroencephalogramNeonatal seizureNeurophysiologyPrematuritySpontaneous neuronal activity

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