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Neonatal Seizures and Infantile-Onset Epilepsies 

Neonatal Seizures and Infantile-Onset Epilepsies
Neonatal Seizures and Infantile-Onset Epilepsies

Elia Pestana Knight

and Ingrid E.B. Tuxhorn

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date: 25 May 2022

In the different sections of this chapter the authors review the current knowledge about neonatal seizures and highlight the areas where there is clear controversy. The chapter begins with the epidemiology and definition of neonatal seizures. It continues with the controversies surrounding whether neonatal seizures should be classified with the epilepsies and epileptic syndrome or independently because not all the patients with neonatal seizures will develop epilepsy. The next section includes a clinical description of neonatal seizures; taking into account its phenomenology (subtle seizures, tonic seizures, clonic seizures and myoclonic seizures). A brief definition of neonatal status epilepticus is also included in this chapter. The following section covers the electroencephalographic biomarkers and characteristics of the ictal and interictal discharges in neonates. This section is followed by the risk factors and etiologies associated to or leading to neonatal seizures. The unique physiopathology of neonatal seizures is highlighted and is next followed by another controversial topic: are seizures per se, dangerous to the developing brain. Management of neonatal seizures still relies on the efficacy of phenobarbital and phenytoin as first line drugs. Secondary line drugs and other novel treatments are highlighted in the treatment section. Morbidity and mortality still remains relatively high for neonates with seizures despite advances in neonatal care in the last 20 years. A section on prognosis of neonatal seizures offers a detailed review of the medical literature documenting this data. The last section briefly describes two idiopathic epilepsy syndromes and two devastating epileptic encephalopathies that begin in the neonatal period.

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