NEONATAL NEUROLOGICAL

EMERGENCIES
 CATEGORIES
SYMPTOMATIC SEIZURES

NEONATAL EPILEPSY SYNDROMES

ACUTE SYMPTOMATIC SEIZURES

Neonatal encephalopathy and hypoxic-ischemic

encephalopathy

Acquired structural brain lesions, including

ischemic and hemorrhagic stroke

Metabolic disturbances

CNS or systemic infections

NEONATAL EPILEPSY SYNDROMES

Benign familial neonatal epilepsy

Early myoclonic encephalopathy

Early infantile epileptic encephalopathy

Additional genetic epilepsies

Epilepsies related to congenital brain

malformations
 PREDICTORS OF OUTCOME
Seizure burden
Status epilepticus
Neurologic examination at the time of seizures
Number of drugs required to treat seizures
Findings on neuroimaging
Gestational age (term versus preterm)/Birth
weight
EEG features
VIDEO-EEG
Gold standard for diagnosis & treatment of
neonatal seizures.

GENETIC TESTING
Be strongly considered in neonates with no
identifiable cause for epilepsy
Suggest using a gene panel for epileptic
encephalopathies and brain malformations,
or whole exome sequencing
 ANTISEIZURE DRUG THERAPY

Decision to institute drug therapy —

Seizure duration
Seizure severity
Seizure etiology.
Copyrights apply
 ENDPOINT OF ACUTE THERAPY
Duration of therapy
Early discontinuation of anti-seizure drugs

Treatment range from one week up to 12 months after the

last seizure

Weaning the medication is often done after the recording

of an EEG that demonstrates no seizures

Decisions about discontinuing medication should take into

consideration the seizure etiology and the seizure severity