Neonatal Seizures
Neonatal seizures are the most common neurological emergency in the newborn period. Unlike in older children, they are often subtle and require a high index of clinical suspicion.
1. Types of Seizures
- Subtle: Most common; includes eye deviation, lip smacking, pedaling movements, or autonomic changes (apnea/tachycardia).
- Clonic: Rhythmic, focal, or multifocal jerking.
- Tonic: Sustained posturing (focal or generalized).
- Myoclonic: Single or multiple focal jerks (often suggest metabolic/genetic etiology).
2. Common Etiologies
| Category | Key Causes |
|---|---|
| Hypoxic-Ischemic | HIE (Hypoxic-Ischemic Encephalopathy) – the most common cause. |
| Infections | Neonatal sepsis, meningitis (GBS, E. coli). |
| Metabolic | Hypoglycemia, Hypocalcemia, Hypomagnesemia. |
3. High-Yield Clinical Pearls
- Jitteriness vs. Seizures: Jitteriness is stimulus-sensitive, stops with passive flexion of the limb, and does not involve eye deviation. Seizures are non-stimulus-sensitive and persist despite restraint.
- First-Line Treatment: Phenobarbital is the standard first-line anticonvulsant. If seizures are refractory, consider Levetiracetam or Phenytoin.
- Metabolic Correctors: Always exclude treatable causes (Check Blood Glucose and Calcium) before or while starting anti-epileptic drugs.
NEET PG Hint: Remember: Hypoxic-Ischemic Encephalopathy (HIE) is the single most common cause of neonatal seizures overall. However, hypoglycemia is the most common *metabolic* cause. For more high-yield neonatology protocols and free medical questions, visit mymedschool.org.