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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Neonatal seizures, as distinguished from nonconvulsive abnormal movements, are a significant problem in neonatal intensive care units. Clinical diagnosis without EEG confirmation is difficult. By virtue of brain metabolic and peripheral physiologic effects, seizures may damage the immature brain. The approach to neonatal seizures should be systematic and directed at establishing the primary etiology. On the basis of tradition, phenobarbital is currently the drug of first choice in the treatment of neonatal seizures. A significant number of neonates with seizures have poor outcomes, and both duration of seizure activity and numbers of anticonvulsants required in treatment predict the outcome.
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PMID:Neonatal seizures. 351 3

Neonatal seizures have been observed as early as the first hour of life. It has been postulated that for certain central nervous system disorders, seizure activity may occur in utero. This report describes two cases of spontaneous fetal seizure activity diagnosed by real-time ultrasound.
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PMID:Antenatal diagnosis of fetal seizure activity with use of real-time ultrasound. 353 5

The temporal behavior of neonatal seizures caused by diverse acute encephalopathies in 42 patients with 487 seizures was studied. All 487 seizures were confirmed by typical ictal electroencephalogram (EEG) patterns. Neonatal seizures are relatively brief events, which usually last about 2 min. They are recurrent and are separated by interictal recovery periods of variable duration, on the average, about 8 min. Solitary prolonged seizures are rare and do not represent the usual behavior of neonatal seizures.
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PMID:The exact ictal and interictal duration of electroencephalographic neonatal seizures. 365 58

Neonatal seizures occurred in 23 infants, a rate of 2.33 per 1000, 1978-81. In two infants these were due to congenital central nervous system malformation and in two infants hypocalcaemia. Hypoxic encephalopathy was the cause of the seizures in 19 infants, two of whom also suffered perinatal trauma. Pacific Island infants were overly represented in this group. The gestational age was 41, SD 1.8 weeks, birth weight 3140, SD 720 g; nine infants were 41 weeks or older although nine had unsure data and nine were small for gestational age. Despite vigorous resuscitation at birth, careful metabolic monitoring in the neonatal period and treatment with anti-convulsant medication, at follow-up evaluation 12 (67%) of the infants with hypoxic encephalopathy died or had neurologic sequelae.
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PMID:Neonatal seizures: aetiology and outcome. 659 79

The current seizure classification recognizes two major categories, partial (focal) and generalized. Sublcasses of this system are determined by clinical and electroencephalographic manifestations of the seizures. Neonatal seizures are difficult to recognize and classify but require prompt and appropriate treatment for best results. Infantile spasms are important to recognize because of their grave prognosis and because they respond to steroid medications but not standard anticonvulsants. Febrile convulsions represent a continuing treatment controversy but have a good prognosis. The diagnosis of epilepsy is based on clinical history. Laboratory studies help classify the type of seizure and identify the etiology. The computerized tomography (CT) scan has simplified diagnostic evaluation. The extent of the evaluation must be adjusted to meet individual requirements. The choice of anticonvulsant is dependent on seizure type as well as the side effects and cost of the drug. Anticonvulsants have potential side effects which can be minimized by judicious dosage adjustments utilizing serum anticonvulsant levels when appropriate.
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PMID:Problems in family practice: Seizure disorders. 676 94

The authors report the long-term outcome and cognitive development in the late-teenage years of 'normal' survivors of neonatal seizures. The outcome of the children was good, and normal in that they had attended normal schools and had normal overall intelligence test scores as adults. However, all of the sample displayed abnormal neuropsychological development in terms of intelligence test profile and subtest scatter, or development of spelling, or development of memory. This was independent of social and behavioural difficulties, which may also be increased. Neonatal seizures may be indicative of a subtle neurodevelopmental vulnerability which may manifest later in life as specific learning difficulties or poor social adjustment.
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PMID:Neonatal seizures: long-term outcome and cognitive development among 'normal' survivors. 753 58

The medical records of 89 children followed at a multidisciplinary Meningomyelocele Clinic at the Children's Clinics for Rehabilitative Services were reviewed. Almost all children in southern Arizona with meningomyelocele are followed at this clinic. Eight children (foreign nationals) were excluded because they were not eligible for neurosurgery/neurology services at the clinic. The remaining 81 children have been followed at the clinic from 0.25 to 21 years. Seventeen children (21%; age: 1.3-17 years, mean: 9.1 +/- 4.4 years; follow-up: 1.3-16 years) manifested seizures at some time during their course. All children with seizures had shunted hydrocephalus. Neonatal seizures occurred in 2 children currently not receiving medication. An additional 3 children had an acute symptomatic seizure associated with an intraventricular hemorrhage during ventriculoperitoneal shunt revision, 2 of whom later developed epilepsy. Fourteen children (17.3%) had epilepsy; 12 were taking antiepileptic drugs. Seizures were controlled on medication in 5 children. EEG abnormalities were present in 12 children (focal slowing 4, focal spikes 8, diffuse slowing 3, generalized or bilaterally synchronous spike-wave 4). Most of these children (12/14) had evidence of additional central nervous system (CNS) pathology (i.e., areas of encephalomalacia or past stroke 7, cerebral malformations 2, CNS calcifications 1, and frequent apneic spells/cardiac arrest 2). We conclude that epilepsy occurs in approximately 17% of children with meningomyelocele, and most have other CNS pathology to account for their seizures.
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PMID:Epilepsy in children with meningomyelocele. 757 45

Investigators disagree on the significance of and the best treatment for neonatal seizures. Each year more data are revealed and the controversy continues. A foundation must be laid for discussing this controversy by reviewing neonatal seizure classification and etiology. Neonatal seizures may occur with and without electroencephalogram (EEG) correlation. Although some seizures may not correlate with an abnormal EEG, they may still be a sign of significant brain dysfunction. The nurse's understanding of these principles and the ability to recognize and report these events will enable the neonate to receive the proper care and treatment in the most expedient manner.
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PMID:Neonatal seizures: the debate continues. 770 40

Neonatal seizures can be difficult to classify according to partial versus generalized onset on the basis of clinical appearance or electroencephalography (EEG). Single-photon emission computed tomography has proven to be useful in adults when adjunctive tests are needed to identify the nature of seizure onset. Although its use has been extended recently to children, the lower age limit at which this technique is useful remains to be established. A case is reported in which ictal Tc-99m HMPAO SPECT of a 16-day-old infant revealed an area of focal hypermetabolism in the right temporal lobe corresponding to an area of focal atrophy revealed by MRI. The EEG of this infant demonstrated multifocal interictal epileptiform abnormalities and an ictal pattern with a generalized onset. This case indicates that ictal SPECT is a useful tool in the evaluation of even the youngest patients with seizures.
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PMID:Ictal SPECT in a 16-day-old infant. 840 21

Neonatal seizures in the neonatal period are symptoms of numerous underlying disorders of the neonate. We present a case in which neonatal seizures due to cerebral infarction led to a diagnosis in the mother. Neonatal convulsions caused by cerebral artery thrombosis is relatively rare in the neonatal period and is often secondary to indwelling intravascular catheters that cause thromboembolism, but may be associated with many conditions.1 Cerebral artery thrombosis in newborns, in which antiphospholipid antibodies (APA) were found in the mother, has been described in three case reports. Two of these premature infants were born with other risk factors for thrombosis. APA could not be identified in any of these three infants. In the two cases reported by Silver et al the diagnosis was made several months after birth. This case is unique in the fact that no other risk factors for thrombosis could be identified to explain the infarction, and that APA were found in the offspring of an apparently healthy mother. Whether the prior fetal death was caused by APA remains unclear. The finding of lupus anticoagulant in her child led to the diagnosis of antiphospholipid antibody syndrome in her. We believe that in case of cerebral artery thrombosis in a neonate, with no trivial cause such as an indwelling catheter or sepsis, both mother and infant should be tested for presence of APA, even when the mother seems healthy.
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PMID:An unusual cause of neonatal seizures in a newborn infant. 931 May 41


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