Neonatal Seizures: Clinical Spectrum, Etiology, and Current Approaches

Area of Science:

• Neonatal neurology
• Pediatric epilepsy

Background:

• Neonatal seizures are neurological emergencies with potential for severe CNS damage.
• Preterm neonates are more susceptible than term neonates.
• Electrographic seizures without clinical signs necessitate electroencephalography (EEG) for diagnosis.

Purpose of the Study:

• To review the classification, diagnosis, and management of neonatal seizures.
• To highlight the importance of identifying underlying etiologies.
• To discuss prognostic factors associated with neonatal seizures.

Main Methods:

• Review of current literature on neonatal seizure classification and management.
• Analysis of diagnostic approaches including clinical examination, history, and neuroimaging.
• Evaluation of first- and second-line anti-seizure medications (ASMs).

Main Results:

• Neonatal seizures are classified into motor and non-motor types.
• Common etiologies include hypoglycemia, electrolyte disturbances, and metabolic diseases.
• Phenobarbital is the first-line ASM, with levetiracetam and phenytoin as second-line options.

Conclusions:

• Prompt diagnosis and intervention are crucial for neonatal seizures.
• Understanding the etiology is key to effective management and prognosis.
• Higher seizure burden correlates with adverse neurodevelopmental outcomes and increased mortality risk.