Neonatal seizure disorders

[Lanell]

Neonatal seizures are abnormal electrical discharges in the central nervous system of neonates and usually manifest as stereotyped muscular activity or autonomic changes. Diagnosis is confirmed by electroencephalography; testing for causes is indicated. Treatment depends on the cause.
(See also Seizure Disorders.)
Seizures occur in up to 1.4% of term infants and 20% of premature infants. Seizures may be related to a serious neonatal problem and require immediate evaluation. Most neonatal seizures are focal, probably because generalization of electrical activity is impeded in neonates by lack of myelination and incomplete formation of dendrites and synapses in the brain.
Some neonates undergoing electroencephalography (EEG) to assess seizures or other symptoms of encephalopathy (eg, hypoactivity, decreased responsiveness) are found to have clinically silent seizures (≥ 20 seconds of rhythmic epileptiform electrical activity during an EEG but without any clinically visible seizure activity). Occasionally, clinically silent electrical activity is continuous and persists for