Understanding Neonatal Seizures

What are neonatal seizures?

Seizures happen due to abnormal electrical brain discharges due to malformations, brain damage, or chemical imbalances. In babies, seizures should be diagnosed immediately and treated to avoid any permanent damage. Seizures not only indicate that there is brain damage but can also cause further damage to the brain.

Seizures are jerking movements that are involuntary, but seizure symptoms in a baby can be difficult to identify and may depend on the kind of seizure the newborn may be having. A lot of neonatal seizures are diagnosed as subtle or subclinical, which means that the newborns do not indicate jerking movements and the seizure can only be identified through EEG monitoring. Hence, if a baby is at risk of having a seizure, he or she should be monitored through an EEG machine at all times.

Types of neonatal seizures

Here are the most common clinical neonatal seizures:

  • Focal tonic-clonic seizures are not very frequent. They involve uncommon extremities, trunk posturing, or abnormal eye movements.
  • Focal clonic seizures can be identified by rhythmic and repetitive movements in the face, limbs, or trunk. The movements are mostly slow.
  • Epileptic spasms in babies are rare and involve limb and trunk muscles. They may happen in clusters when the baby wakes up.
  • Myoclonic seizures can be identified through contractions in the trunk, limb, face, or diaphragm muscle groups. The movements can be slow or fast, depending on the size of the muscles involved. These kinds of seizures can be repetitive or isolated incidents.

Causes of neonatal seizures

Neonatal seizures can happen due to many things, such as birth injuries. Other reasons include the following:

  • Seizures can happen due to infections such as herpes encephalitis, meningitis, toxoplasmosis, and cytomegalovirus.
  • The most common reason for neonatal seizures is birth asphyxia or HIE. HIE is a medical issue where a baby is deprived of oxygen at birth.
  • Seizures can happen due to the brain injury suffered by the newborn during the birthing process. If the foetus's position or size is incorrect, it can result in birth injuries and neonatal seizures.

How do you diagnose neonatal seizures?

EEG is the main diagnostic test for checking seizure activity and deciding which part of the baby's brain is affected. During the EEG, the baby's head is attached with electrodes, which monitor the electrical activity in the baby's brain and indicate if there are any changes. The results can be seen on printed strips and screen.

Treatment of neonatal seizures

Although neonatal seizures are rather frequent, there are still few effective treatments available. The most often prescribed drugs to treat newborn seizures historically have been phenobarbital and phenytoin/fosphenytoin. The cause is typically the focus of all therapy.


If you believe your baby is having a neonatal seizure, you need medical help immediately. After your baby is treated, you must talk to her or his doctor about what steps to take if the seizures happen again.

Request an appointment at Apollo Cradle, Bengaluru - Jayanagar. Call 1860-500-1066 to book an appointment.

1. Which type of neonatal seizure has the best prognosis?

The prognosis of neonatal seizures that happen due to isolated subarachnoid hemorrhage is better, with 90% of kids not having any residual neurologic deficits.

2. How long does it take to treat a neonatal seizure?

Usually, acutely symptomatic neonatal seizures remit in around 72 hours. Still, babies are often prescribed ASMs for years or months by doctors, as parents are often concerned about the chances of early-life epilepsy and continued seizures.

3. What complications do neonatal seizures cause?

Complications due to frequent or prolonged neonatal seizures can include spasticity or cerebral palsy, global developmental delay, epilepsy, swallowing problems, or feeding issues.

4. What deficiencies can lead to neonatal seizures?

PDE is a very rare reason for difficult-to-manage, stubborn neonatal seizures. Seizures due to PDE can also happen in infants and older children.

5. Can oxygen deprivation cause neonatal seizures?

Neonatal seizures happen in the first 72 hours of the baby's life and can include clinic, subtle, or generalized seizures. These kinds of seizures happen due to a brain injury caused by a lack of blood and oxygen called HIE.

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