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Summary
Neonatal seizures lack a standardized evaluation and treatment approach. This survey reveals significant variation among specialists in diagnostic workups and medication choices for infant seizures.
Area of Science:
- Pediatric Neurology
- Neonatology
Background:
- Neonatal seizures are a critical concern in newborn care.
- Current practices for diagnosis and management lack uniformity.
Purpose of the Study:
- To survey neonatologists and pediatric neurologists on their evaluation and management strategies for neonatal seizures.
- To identify variations in diagnostic workups and therapeutic interventions.
Main Methods:
- A nationwide survey was distributed to 750 neonatologists and pediatric neurologists.
- Response rate was 38% (284 physicians).
Main Results:
- Most respondents routinely perform glucose, calcium, electrolyte tests, and lumbar punctures.
- Significant variability exists in the use of electroencephalography (EEG), CT scans, and drug screens.
- Phenobarbital and phenytoin are common first and second-line drugs, with neurologists using higher loading doses.
- Maintenance doses are typically adjusted based on blood levels.
- Treatment duration varies from two months to one year, with discontinuation criteria often arbitrary.
Conclusions:
- There is a notable lack of consensus in the evaluation and management of neonatal seizures among surveyed specialists.
- Standardized guidelines may be needed to improve consistency in care for infants experiencing seizures.