Updates in Neonatal Seizures

Neonatal seizures are a common medical emergency, necessitating prompt treatment. The most common etiologies include hypoxic-ischemic encephalopathy, ischemic stroke, and intracranial hemorrhage, with numerous other uncommon etiologies. Accurate diagnosis requires conventional video-electroencephalogram (cvEEG) to distinguish seizures from nonepileptic movements and to detect electrographic-only (subclinical) seizures. Treatment prioritizes rapid medication administration, with phenobarbital as first-line treatment and the only Federal Drug Administration (FDA)-approved medication for neonatal seizures. Prognosis depends on seizure etiology and severity. Advances in artificial intelligence show promise for improved seizure detection and prognostication. Further research and randomized controlled trials of novel medications are needed.