How are neonatal convulsions treated?

Administration of antiepileptic medications should be instituted in an orderly and efficient manner. Initial treatment with phenobarbital should be considered. If seizures persist, phenytoin should be added. Persistent seizures may require the use of an intravenous benzodiazepine, such as lorazepam or midazolam.

What is benign familial neonatal convulsions?

Benign familial neonatal seizures (BFNS) is a condition characterized by recurrent seizures in newborn babies. The seizures begin around day 3 of life and usually go away within 1 to 4 months. The seizures can involve only one side of the brain (focal seizures) or both sides (generalized seizures).

What is the drug of choice for neonatal seizures?

Phenobarbital is the most commonly used AED for treating neonatal seizures. The dosage aims at reaching a level in the baby’s blood (a free plasma concentration) of at least 25 micrograms per milliliter (mcg/mL). Dilantin (phenytoin) is the second most commonly used medication.

Can neonatal seizures be cured?

For benign neonatal seizures, the effect of anti-epileptic drugs is not clear, since many seizures go away on their own. However, the baby will usually be given anti-epileptic drugs at least for a short period.

What is the most common cause for a child to have a convulsion?

The most common type of seizure in children is from a fever (called a febrile seizure). Other causes include infections, low blood sodium, medicines, drug use (amphetamines or cocaine), brain injury or a tumor, and genetic changes. Sometimes, a seizure’s cause is never found.

Why is Diazepam not given to neonates?

Diazepam is generally avoided in neonates because of its short duration of antiepileptic effect but very prolonged sedative effect, narrow therapeutic index, and the presence of sodium benzoate as a preservative.

What is a benign seizure?

Benign rolandic epilepsy (BRE) is the most common form of childhood epilepsy. It is referred to as “benign” because most children outgrow the condition by puberty. This form of epilepsy is characterized by seizures involving a part of the brain called the rolandic area.

How can you tell if a seizure is neonate?

Signs & symptoms

1. Random or roving eye movements, eyelid blinking or fluttering, eyes rolling up, eye opening, staring.
2. Sucking, smacking, chewing and protruding tongue.
3. Unusual bicycling or pedalling movements of the legs.
4. Thrashing or struggling movements.
5. Long pauses in breathing (apnea)

How long do neonatal seizures last?

The duration of neonatal seizures is usually brief (10 s to 1–2 min) and repetitive with a median of 8 min in between each seizure. Longer seizures and status epilepticus develop more readily at this age, but convulsive neonatal status epilepticus is not as severe as that of older infants and children.

How long do baby seizures last?

This most common type lasts from a few seconds to 15 minutes. Simple febrile seizures do not recur within a 24-hour period and are not specific to one part of the body. Complex febrile seizures.

How do you treat a convulsion at home?

First Aid

1. Keep other people out of the way.
2. Clear hard or sharp objects away from the person.
3. Don’t try to hold them down or stop the movements.
4. Place them on their side, to help keep their airway clear.
5. Look at your watch at the start of the seizure, to time its length.
6. Don’t put anything in their mouth.

What is the prognosis for benign neonatal convulsions?

Prognosis. The risk of seizures later in life is 11-16% in benign familial neonatal convulsions (BFNCs) and somewhat less in benign idiopathic neonatal convulsions (BINCs), perhaps as low as 2%. Other reported problems have been sporadic and within the incidence range expected for the general population.

When to use anticonvulsant therapy in neonatal?

The use of anticonvulsant therapy (e.g. phenobarbital, phenytoin, valproate, carbamazepine) is needed in most cases to stop seizures in the neonatal period, particularly in cases with very frequent seizures or status epilepticus. Usually, patients require treatment for the first 6-12 months of life.

When does benign familial neonatal epilepsy ( BFNE ) occur?

Benign familial neonatal epilepsy (BFNE) is a rare genetic epilepsy syndrome characterized by the occurrence of afebrile seizures in otherwise healthy newborns with onset in the first few days of life.

What causes convulsions in the neonatal period?

Potassium channel abnormalities. This defect leads to abnormal repolarization of the neuronal membrane and likely causes the neonatal seizures. The real puzzle is why this profound abnormality in membrane polarization does not lead to more problems in later life or persistent seizures extending from the neonatal period.

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