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Medicines in neonates
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
As previously discussed, the most difficult issues in the diagnosis of neonatal seizures are (a) to decide which atypical ictal behavioural events can be regarded as epileptic seizures and (b) whether subclinical EEG seizures are occurring. For both purposes, EEG monitoring is essential and should be prolonged to answer the question regarding subclinical seizures. Aetiological context and global neurological evaluation provide a solid, and indispensable, basis for decision-making [11].
Neonatal Seizures
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
As already emphasized, the management of neonatal seizures is primarily directed at their causal factors. At this time specific therapy is available for only a few of these factors (metabolic derangements, postnatal infections), thus traditional AED treatment is often the only therapeutic option available. More specific therapeutic modalities will be available only when the mechanisms of injuries that cause most neonatal seizures are understood, thus allowing measures of prevention rather than only symptomatic treatments.
The neonate
Published in Louise C Kenny, Jenny E Myers, Obstetrics, 2017
Seizures are relatively common in the newborn period, affecting 1–2 per 1,000 livebirths. Hypoxic-ischaemic encephalopathy is the most common cause of neonatal seizures, causing about half of neonatal seizures. However, there is a broad differential. Other causes of neonatal seizures include: cerebral infarction (stroke); intracranial haemorrhage (intraventricular haemorrhage and subdurals); meningitis; electrolyte disturbances (hypocalcaemia, hypomagnesemia); and hypoglycaemia.
Aberrant plasticity in the hippocampus after neonatal seizures
Published in International Journal of Neuroscience, 2018
Xiaoqian Zhang, Huiling Qu, Ying Wang, Shanshan Zhao, Ting Xiao, Chuansheng Zhao, Weiyu Teng
However, few studies have reported ectopic migration after neonatal seizures. Recently, it has been reported that neonatal rats subjected to hypoxia treatment on P10 when examined one month after the insults had more ectopic migration of newborn neurons in hilus in comparison with the controls [47]. Germano et al. induced experimental neuronal migration disorders by exposing pregnant rats to methylazoxymethanol acetate and found that rats with neuronal migration disorders required less stimulation to develop seizures than controls, indicating that hippocampal kindling could be facilitated by the presence of severe neuronal migration disorders in the immature brain [50]. McCabe et al. showed that the overwhelming majority of neural precursor cells differentiated into DGCs within the dentate gyrus even after recurrent flurothyl-induced seizures between P0 and P4 in rats, indicating that neonatal seizures might not impair the migration of newly formed neurons compared with adult seizures [41]. The explanation may be that the neonatal seizures cause little neuronal damage, and the lack of neuronal damage in the neonatal models results in a lack of ectopic migration of neurons. Mossy fiber sprouting.
The role of electroencephalogram in neonatal seizure detection
Published in Expert Review of Neurotherapeutics, 2018
Francesco Pisani, Elena Pavlidis
Seizures are frequent in the neonatal period.Neonatal seizures are the sign of a brain insult and can add damage themselves.Detecting neonatal seizures is crucial in order to provide a good level of critical care.Multichannel video-EEG monitoring is the gold standard in order to detect neonatal seizures.It also provides information on background activity and prognosis.
EEG in neonatal seizures: where to look and what to see
Published in Expert Review of Neurotherapeutics, 2022
Francesco Pisani, Carlotta Spagnoli
First, neonatal seizures are a frequent phenomenon, especially in high-risk newborns. Due to the remarkable improvements in neonatal and perinatal intensive care, an ever-growing number of high-risk newborns are now surviving. More than 30% of the infants affected by hypoxic-ischemic encephalopathy, intraventricular hemorrhage, brain infections, or stroke experience acute symptomatic seizures [1–4]. As an example, in a recent paper, of the 59 neonates with moderate HIE, 27 (46%) had seizures, while 17 of the 24 (71%) neonates with severe HIE had seizures, and numbers were also high for neonates with metabolic/genetic disorders (16/20, 80%) and stroke (10/18, 56%) [4].