Seizures in neonates: diagnosis and management in the emergency department

Neonatal seizures are associated with high morbidity and mortality, but they can be difficult to diagnose because they often present with subtle signs and symptoms. Initial management goals in the emergency department include patient stabilization, seizure cessation, and determination of the etiology; identification of life-threatening treatable causes of the seizures should be prioritized. Further management depends on the history and physical examination findings, laboratory testing results, and imaging studies. This issue reviews common presentations and causes of neonatal seizures, considerations for emergency department management, and the evidence regarding antiepileptic medications for neonates.