Skip to main content

Neonatal Seizures

  • Chapter
  • First Online:
Handbook of Pediatric Epilepsy
  • 1027 Accesses

Abstract

Seizures are the clinical expression of a vast array of pathology in the neonatal period, from hypoxic ischemic encephalopathy to infections and metabolic derangements. Neonatal seizures have unique semiology and frequently occur without clear clinical symptoms. This chapter summarizes the presentation, etiology, and treatment of neonatal seizures.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 84.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Glass HC, Shellhaas RA, Wusthoff CJ, et al. Contemporary profile of seizures in neonates: a prospective cohort study. J Pediatr. 2016;174:98–103.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Tekgul H, Gauvreau K, Soul J. The current etiologic profile and neurodevelopmental outcome of seizures in term newborn infants. Pediatrics. 2006;17(4):1270–80.

    Article  Google Scholar 

  3. Garcias Da Silva LF, Nunes ML, da Costa JC. Risk factors for developing epilepsy after neonatal seizures. Pediatr Neurol. 2004;30:271–7.

    Article  PubMed  Google Scholar 

  4. Garfinkle J, Shevell MI. Cerebral palsy, developmental delay, and epilepsy after neonatal seizures. Pediatr Neurol. 2011;44:88–96.

    Article  PubMed  Google Scholar 

  5. Mellits ED, Holden KR, Freeman JM. Neonatal Seizures II. A multivariate analysis of factors associated with outcome. Pediatrics. 1982;70(2):177–85.

    Article  CAS  PubMed  Google Scholar 

  6. Holmes GL. Effects of seizures on brain development: lessons from the laboratory. Pediatr Neurol. 2005;33:1–11.

    Article  PubMed  Google Scholar 

  7. Van Rooij LGM, Toet MC, van Huffelen AC. Effect of treatment of subclinical neonatal Seizures detected with aEEG: randomized. Controlled Trial Pediatrics. 2010;125(2):e358–66.

    PubMed  Google Scholar 

  8. Hellstrom-Westas L, Boylan G, Agren J. Systematic review of neonatal seizure management strategies provides guidance on anti-epileptic treatment. Acta Paediatr. 2015;104(2):123–9.

    Article  PubMed  Google Scholar 

  9. Volpe JJ. Neonatal seizures in neurology of the newborn. 5th ed. Philadelphia: Saunders Elsevier; 2008. p. 203–44.

    Book  Google Scholar 

  10. Facini C, Spagnoli C, Pisani F. Epileptic and non-epileptic paroxysmal motor phenomena in newborns. J Matern Fetal Neonatal Med. 2016;29(22):3652.

    Article  PubMed  Google Scholar 

  11. Mizrahi EM, Kellaway P. Characterization and classification of neonatal seizures. Neurology. 1987;37:1837–44.

    Article  CAS  PubMed  Google Scholar 

  12. Murray DM, et al. Defining the gap between electrographic seizure burden, clinical expression and staff recognition of neonatal seizures. Ach Dis Child Fetal Neonatal. 2008;93:F187–91.

    Article  CAS  Google Scholar 

  13. Shellhaas RA, Chang T, Tsuchida T. The American clinical neurophysiology society’s guideline on continuous electroencephalography monitoring in neonates. J Clin Neurophysiol. 2011;28(6):611–7.

    Article  PubMed  Google Scholar 

  14. Allen NM, et al. The variable phenotypes of KCNQ-related epilepsy. Epilepsia. 2014;55(9):e99–105.

    Article  Google Scholar 

  15. Axeen EJT, Olson HE. Neonatal epilepsy genetics. Seminars Fetal Neonatal Med. 2018;23(3):197–203.

    Article  Google Scholar 

  16. Hallberg B, Blennow M. Investigations for neonatal seizures. Semin Fetal Neonatal Med. 2013;18(4):196–201.

    Article  CAS  PubMed  Google Scholar 

  17. Ficicioglu C, Bearden M. Isolated neonatal seizures: when to suspect inborn errors of metabolism. Pediatr Neurol. 2011;2011(45):283–91.

    Article  Google Scholar 

  18. Pisani F, Percesepe A, Spagnoli C. Genetic diagnosis in neonatal-onset epilepsies: Back to the future. Eur J Paediatr Neurol. 2018;22(3):354–7.

    Article  PubMed  Google Scholar 

  19. Bittigau P, Sifringer M, Ikonomidou C. Antiepileptic drugs and apoptosis in the developing brain. Ann New York Acad Sci. 2003;993:103–14.

    Article  CAS  Google Scholar 

  20. Donovan MD, Griffin BT, Kharoshankaya L, Cryan JF, Boylan GB. Pharmacotherapy for neonatal seizures: current knowledge and future perspectives. Drugs. 2016;76(6):647–61.

    Article  CAS  PubMed  Google Scholar 

  21. Boylan GB, et al. Second-line anticonvulsant treatment of neonatal seizures. Neurology. 2004;63:486–8.

    Article  Google Scholar 

  22. Painter MJ, et al. Phenobarbital compared with phenytoin for the treatment of neonatal seizures. N Engl J Med. 1999;341:485–9.

    Article  CAS  PubMed  Google Scholar 

  23. Sharpe C, Reiner GE, Davis SL. Levetiracetam versus phenobarbital for neonatal Seizures: a randomized controlled trial. Pediatrics. 2020;145(6):e20193182.

    Article  PubMed  Google Scholar 

  24. Gospe SM. Neonatal vitamin-responsive epileptic encephalopathies. Chang Gung Med J. 2010;33:1–12.

    PubMed  Google Scholar 

  25. Puneet J, Sharma S, Dua T. Efficacy and safety of anti-epileptic drugs in patients with active convulsive seizures when no IV access is available: systematic review and meta-analysis. Epilepsy Res. 2016;122:47–55.

    Article  Google Scholar 

  26. Booth D, Evan DJ. Anticonvulsants for neonates with seizures. Cochrane Database Syst Rev. 2004;3:CD004218.

    Google Scholar 

  27. Bergman A, et al. Neuronal losses in mice following both prenatal and neonatal exposure to phenobarbital. Acta Anat. 1982;114:185–92.

    Article  CAS  PubMed  Google Scholar 

  28. Fishman RHB, et al. Ultrastructural evidence of long-lasting cerebellar degeneration after early exposure to phenobarbital in mice. Exp Neurol. 1983;79:212–20.

    Article  CAS  PubMed  Google Scholar 

  29. Pick CG, Yanai J. Long-term reduction in eight arm maze performance after early exposure to phenobarbital. Int J Dev Neurosci. 1985;3:223–7.

    Article  CAS  PubMed  Google Scholar 

  30. Schain RJ, Watanabe K. Effect of chronic phenobarbital administration upon brain growth of the infant rat. Exp Neurol. 1975;47:509–17.

    Article  CAS  PubMed  Google Scholar 

  31. Yanai J, et al. Neural and behavioral alterations after early exposure to phenobarbital. Neurotoxicology. 1989;10:543–54.

    CAS  PubMed  Google Scholar 

  32. Dessens AB, et al. Association of prenatal phenobarbital and phenytoin exposure with small head size at birth and with learning problems. Acta Pediatrics. 2000;89(5):533–41.

    Article  CAS  Google Scholar 

  33. Farwell JR, et al. Phenobarbital for febrile seizures—effects on intelligence and on seizure recurrence. NEJM. 1990;322:364–9.

    Article  CAS  PubMed  Google Scholar 

  34. Dzhala VI, et al. NKCC1 transporter facilitates seizures in the developing brain. Nat Med. 2005;11(11):1205–13.

    Article  CAS  PubMed  Google Scholar 

  35. Dzhala VI, et al. Bumetanide enhances phenobarbital efficacy in neonatal seizure model. Ann Neurol. 2008;63:222–35.

    Article  CAS  PubMed  Google Scholar 

  36. Kahle KT. Decreased seizures activity in a human neonate treated with bumetanide. J Child Neuro. 2009;24:572–6.

    Article  Google Scholar 

  37. Pressler RM, Boylan GB, Marlow N. Bumetanide for the treatment of seizures in newborn babies with hypoxic ischaemic encephalopathy (NEMO): an open-label, dose finding, and feasibility phase 1/2 trial. Lancet Neurol. 2015;14:469–77.

    Article  CAS  PubMed  Google Scholar 

  38. Law AJ, Weickert CS, Webster MJ. Expression of NMDA receptor NR1, NR2A,and NR2B subunit mRNAs during development of the human hippocampal formation. Eur J Neurosci. 2003;18:1197–205.

    Article  PubMed  Google Scholar 

  39. Jansen FE. Developmental factors regulating susceptibility to perinatal brain injury and seizures. Current Op Pediatrics. 2006;18:628–33.

    Article  Google Scholar 

  40. Glass HC, et al. Topiramate for the treatment of neonatal seizures. Pediatr Neurol. 2011;44:439–42.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Glier C, et al. Therapeutic doses of topiramate are not toxic to the developing rat brain. Exp Neurol. 2004;187:403–9.

    Article  CAS  PubMed  Google Scholar 

  42. Jensen FE, Blume H, Alvarado S, Firkusny I, Geary C. NBQX blocks acute and late epileptogenic effects of perinatal hypoxia. Epilepsia. 1995;36(10):966–72.

    Article  CAS  PubMed  Google Scholar 

  43. Manthey D, et al. Sulthiame but not levetiracetam exerts neurotoxic effect in the developing rat brain. Exp Neurol. 2005;193:497–503.

    Article  CAS  PubMed  Google Scholar 

  44. Abend NS. Levetiracetam for the treatment of neonatal seizures. J Child Neurol online edition. 2011.

    Google Scholar 

  45. Fuhrwentsches A. Levetiracetam in the treatment of neonatal seizures: a pilot study. Seizure. 2010;19:185–9.

    Article  Google Scholar 

  46. Khan O. Use of intravenous Levetiracetam for Management of Acute Seizures in neonates. Pediatr Neurol. 2011;44:265–9.

    Article  PubMed  Google Scholar 

  47. Khan O, et al. Role of intravenous levetiracetam for acute seizure management in preterm neonates. Pediatr Neurol. 2013;49(5):340–3.

    Article  PubMed  Google Scholar 

  48. Picker M, Thomas J, Koch C, Ramantani G, et al. Levetiracetam: safety and efficacy in neonatal seizures. Eur J Pediatr Neurol. 2011;15:1–7.

    Article  Google Scholar 

  49. Rakshasbhuvankar A, et al. Intravenous levetiracetam for treatment of neonatal seizures. J Clin Neurosci. 2013;20(8):1165–7.

    Article  CAS  PubMed  Google Scholar 

  50. Shoemaker MT. Levetiracetam for the treatment of neonatal seizures. J Child Neurol. 2007;22(1):95–8.

    Article  PubMed  Google Scholar 

  51. Guillet R, Kwon JM. Prophylactic phenobarbital administration after resolution of neonatal Seizures: survey of current practice. Pediatrics. 2008;122(4):731–5.

    Article  PubMed  Google Scholar 

  52. World Health Organization. Guidelines on neonatal seizures. 2011.

    Google Scholar 

  53. Holden KR, Mellits ED, Freeman JM. Neonatal Seizures 1. Correlation of prenatal and perinatal events with outcomes. Pediatrics. 1982;70(2):165–76.

    Article  CAS  PubMed  Google Scholar 

  54. Wirrell EC, Armstrong EA, Osman LD. Prolonged Seizures exacerbate perinatal hypoxic-ischemic brain damage. Pediatr Res. 2001;50:445–54.

    Article  CAS  PubMed  Google Scholar 

  55. Vannucci RC, Towfighi J, Brucklacher RM, Vannucci SJ. Effect of extreme hypercapnia on hypoxic–ischemic brain damage in the immature rat. Pediatr Res. 2001;49:799–803.

    Article  CAS  PubMed  Google Scholar 

  56. Miller SP, Weiss BS, Barnwell A. et al. Seizure-associated brain injury in term newborns with perinatal asphyxia.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David C. Dredge .

Editor information

Editors and Affiliations

Electronic Supplementary Material

Video 5.1

Temporal lobe seizure (MOV 2411 kb)

Video 5.2

Neonatal focal clonic seizure (MP4 55038 kb)

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Dredge, D.C. (2022). Neonatal Seizures. In: Dredge, D.C. (eds) Handbook of Pediatric Epilepsy. Springer, Cham. https://doi.org/10.1007/978-3-319-08290-5_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-08290-5_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-08289-9

  • Online ISBN: 978-3-319-08290-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics