Neonatal seizures and electrographic analysis: evaluation and outcomes

Issues exist in the diagnosis, evaluation, management, and outcome of neonatal seizures. Electroencephalographic data are essential in the characterization, description, and classification of these events, as clinical inspection alone may lead to significant errors in underestimation or overestimation of seizures. This review discusses ictal characteristics of neonatal seizures as well as electrographic status epilepticus. The long-term benefit of treatment of electrographic seizures has never been proved. Prognosis is of critical concern in neonates with seizures and electroencephalographic data yield significant predictive information. Background analysis is most reliable in infants with normal or markedly abnormal recordings. Other ictal features may provide insight into specific outcomes (e.g., development of cerebral palsy). Mortality and neurologic morbidity (including postnatal epilepsy) remain major risks.