Seizures in neonates can have major implications, including significant cognitive and physical

deficits, permanent epilepsy, and death. They are frequently resistant to therapy, in part
because newborn seizures differ fundamentally from seizures in later children and adults.
NEONATAL SEIZURES DUE TO LACK OF OXYGEN BEFORE OR DURING BIRTH OR
COMPRESSION OF THE UMBILICAL CORD. CHILDREN SEIZURES ARE OFTEN DUE TO
GENETIC CAUSES AND MALFORMATION OF CEREBRAL DEVELOPMENT WHILE ADULTS
ARE DUE TO HEAD TRAUMA AND TUMORS. Despite this, they are treated in much the same
way as older patients, with little variation over the years.

Research was done by Janet Soul, MD, director of the Fetal-Neonatal Neurology Program at
Boston Children's Hospital to six other sites evaluated neonates with clinically suspected or
electrographic seizures. There are sixty-four percent of 426 sequentially hospitalized newborns
experienced seizures that did not respond to the initial antiseizure medication, sixteen percent
developed status epilepticus, and seventeen percent died in the neonatal ICU. Most importantly,
greater seizure severity was linked to poorer outcomes, including death. After this research,
Soul has prompted the use of an entirely new seizure treatment that one suited to neonates'
unusually excitable brain with a pilot randomized trial to test bumetanide. Bumetanide are loop
diuretics drugs that are used to regulate and treat fluid overload disorders such as nephrotic
syndrome and inhibits the chloride inhibits the chloride cotransporter NKCC1, present on
many cells.

According to the Annals of Neurology, the bumetanide-treated infants had a considerably higher
reduction in seizure burden by minutes per hour of seizure activity from baseline. The stronger
the effect, the larger the bumetanide dose and amount of medication in the babies are needed.
By the time that the comparative effectiveness study has been completed, it has proven to have
a relatively low rate of seizures to be resurfaced in the first two years after discharge, and even
fewer infants had seizures within the first three months after discharge. This findings has the
potential to make an impact since discontinuing of anti seizures drug is commonly done after
three months of age. As the Network of Excellence in Neuroscience Clinical Trials, Boston
Children's continues to prepare to lead a larger, more conclusive Phase IIb bumetanide
experiment (NeuroNEXT). It offers recommendations to make a more effective treatment for
seizures in newborns.

Reflection:
As a nursing student, I am working to be the woman who people turned to when they were hurt,
sick, weak, and the one who could provide care that might save a life. To become that person,
nursing students must have characteristics not just only to have therapeutic relationships with
patients, but also to be flexible when it comes to different fields. Nurses must be knowledgeable
about new types of intervention that may help its patient increase its recovery stage. We must
be the one to initiate early diagnostic work since we are the most exposed to patients at the
start of its admission. Though it is a trial and error treatment, it is best to test and experiment for
greater benefits to all future clients. Overall, for us to lead in a direction where we have now
become nurses, we must recognize our obligation, treat our patients equally, and focus on
saving lives.

Up-regulation of NKCC1 in neurons has been shown to be involved in neonatal seizures and in
ammonia toxicity-induced seizures. protein that aids in the secondary active transport of
sodium, potassium, and chloride into cells.