0 Neonatal Seizures

Neonatal Seizures

Most Common cause : HIE ( Hypoxic Ischemic Encephalopathy )

Many neonatal seizures are Metabolic.

Day 1 :
  • Hypo-Glycemia
  • Hypo-Calcemia
  • Hypo-Magnesemia
  • IVH
  • Rarely - Pyridoxine dependent seizures.

Day 3 - 7 :
  • Late Onset sepsis
  • Late Onset Hypo-Calcemia
  • Tetanus Neonatorum
  • Kernicterus

Most Common type : Subte Seizures
  • Vacant Stare
  • Paddling movements
Because : 
  1. Myelination is not completed in NewBorn
  2. Arborization of neurons is not completed

DOC : Phenobarbitone (But 1st check Glucose , Calcium , Magnesium )

Not Diazepam - it has Benzyl Alconium Chloride (preservative) which binds to albumin and displaces bilirubin - therefore can precipitate Kernicterus.

 Pyridoxine dependent seizures : (AR) 

Diagnosis of exclusion

Previously diagnosed by response of IV or Oral Pyridoxine ( Used in India Now also )

Diagnosed Now by : CSF or Plasma - Pyridoxine-5-phosphate.

GABA is formed from Pyridoxine 
Therefore if decreased Pyridoxine - decreased GABA - Therefore decrease Inhibitory stimulus.

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