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Emergency: requires immediate attention
Neonatal seizures
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Emergency: requires immediate attention

Neonatal seizures

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Contributors: Jamie Adams MD, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed

Synopsis

Neonatal seizures are defined as those occurring in the first 28 days of life of a full-term baby. Seizures in newborns may be subtle and are often more fragmentary and less coordinated than seizures in children or adults because the brain is still developing. Seizures can be tonic, clonic, myoclonic, or subclinical. Clinically, there may be sudden jerking of the whole body, stiffening and/or twitching of one limb or multiple limbs, gaze deviation, or changes in heart rate or respiratory rate. Events typically last 10 seconds to 2 minutes.

Neonatal seizures can result from infection, electrolyte abnormalities, brain malformations or injury (eg, perinatal stroke, hemorrhage, hypoxic ischemic injury), drug withdrawal, metabolic disorders, genetic disorders, or be idiopathic. Hypoxic-ischemic injury is the most common cause. Prognosis varies depending on the cause, from complete resolution of seizures to long-term cognitive and developmental issues and even death.

Codes

ICD10CM:
P90 – Convulsions of newborn

SNOMEDCT:
87476004 – Convulsions in the newborn

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Stroke – generally symptoms would not fluctuate
  • Intracerebral hemorrhage – imaging would be diagnostic
  • Normal newborn behaviors
  • Jitteriness
  • Hyperekplexia
  • Sleep myoclonus

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed: 03/17/2017
Last Updated: 03/13/2018
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Emergency: requires immediate attention
Neonatal seizures
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Neonatal seizures (Subtle ) : Apnea
Copyright © 2019 VisualDx®. All rights reserved.