What Are Neonatal Seizures and What Does It Mean If a Baby Has Them? | Juthow.com

 They are described as a rapid, paroxysmal, abnormal change in electrographic activity that can appear at any time between delivery and the conclusion of the neonatal period.

Neonatal convulsions are instances of abnormal brain electrical activity that take place within the first 28 days of existence. They frequently indicate severe underlying conditions that could be fatal or require lengthy therapy.

What are neonatal seizures?

When the brain's electrical energy alters, seizures take place. Neonatal seizures are those that happen within the first 28 days of a full-term infant's existence or the first 44 weeks of a premature baby's development. 

Neonatal seizures, one of the most frequent medical crises in newborns, may be challenging to spot in children this young because the signs may be subtle. 

Finding the source of neonatal seizures is essential to know the conditions an infant has and the most effective method to address them because they are one of the most prevalent symptoms of neurological problems in a baby.

What are the types of neonatal seizures?

Neonatal seizures can be focal, affecting just one region or limb, generalized, affecting the complete body, and multifocal, impacting more than one leg. 

Neonatal convulsions can be of four major types:

Minor Convulsions

Neonatal convulsions in some newborns can cause odd movements, also known as "subtle seizures." These motions, which are more typical in full-term babies, include the following actions:

Mouth movements

Gnawing, sticking out the tongue, biting, and swallowing

Eye movements

Eye rolling or wandering, blinking or fluttering, gazing, or erratically or wildly moving the eyes

Body movements

Pedalling with the feet and legs, thrashing, struggling, and taking lengthy breath breaks

Even though subtle convulsions may not always be visible on an electroencephalogram (EEG), they are typically a symptom of a disease that affects the brain's structure or function.

Clonic seizures

One or both sides of the torso as well as one limb or leg can experience clonic seizures. They are quick, jerky motions that typically result in electrical proof on an EEG test.

Tonic seizures

One limb or leg may be the only part of the body to experience tonic convulsions. They exhibit an abrupt tightening trait. EEG examinations may reveal tonic convulsions.

Tonic-clonic seizures

These events, which are also referred to as grand mal seizures, are what most people picture when they think of seizures. These seizures commence with the tonic phase (an abrupt stiffening of the body), followed by the clonic phase, combining the traits of both clonic and tonic seizures. (jerky, rhythmic shaking).

Myoclonic seizures

Myoclonic seizures can either be multifocal, affecting more than one organ or region of the body, or focal, affecting just one. Usually, they consist of a single motion or quickly repeated, nonrhythmic movements.

 Myoclonic seizures, like subtle seizures, may not always be visible on an EEG and are typically a symptom of conditions that impact the anatomy or function of the brain.

What are the signs and symptoms of neonatal seizures?

Depending on the sort of neonatal seizure an infant has, neonatal seizure signs will vary. These signs could consist of:

  • continuous but brief stiffening of the neck or body
  • repetitive, rhythmic contractions of the face, arms, legs, neck, or torso
  • unusual facial expressions, eye movements, or mouth movements

What causes neonatal seizures?

Neonatally induced seizures are brought on by brain-related conditions. They could be brought on by a variety of circumstances. The most frequent reasons include:

  • brain infection (intracranial infections)
  • there’s a problem with the baby’s brain development (congenital brain malformations)
  • bleeding in the brain (intracranial haemorrhage)
  • the baby’s brain doesn’t get enough oxygen (hypoxic-ischemic encephalopathy (HIE))
  • the baby has a stroke that stops oxygen flow in part of the brain (focal ischemic stroke)
  • conditions that affect biochemical processes in the baby’s body (metabolic disorders)

How are neonatal seizures diagnosed?

While some neonatal seizures happen on their own without a reason or stimulus, others do. For therapy and prognosis, it's crucial to identify the source of a baby's seizures. The following tests are used to identify newborn seizures:

Continuous EEG monitoring

The EEG test uses small electrodes that are either worn on the cranium in a cap or gently adhered to the skin to detect the electrical activity of the brain. An infant is watched while undergoing constant EEG tracking so that symptoms can be observed on camera and compared to the EEG readings.


Using radio waves and electromagnets, MRI creates precise pictures of the brain.

CT scan

CT scans can generate precise pictures of soft organs, blood vessels, and bones using computers and X-rays.

What is the treatment for neonatal seizures?

The course of treatment for neonatal convulsions will rely on the underlying reason. While some newborn seizures may resolve on their own, others may require therapies like:

Medicines that prevent convulsions, such as:

  • phenobarbital
  • carbamazepine
  • levetiracetam
  • topiramate
  • phenytoin
  • sodium channel blockers

Antibiotics are examples of medicines for other diseases that result in neonatal convulsions.

After delivery, for a few hours or days, the baby's brain and body are cooled with hypothermic therapy.

What are the risk factors for neonatal seizures?

Obstetric risk factors, or events that happen during pregnancy and birth, as well as baby risk factors, may exist. The following are maternal risk factors for an infant's newborn seizures:

  • first pregnancy
  • fever or infections in labour
  • maternal diabetes
  • maternal smoking
  • post-term deliveries
  • maternal obesity
  • a second episode of labour that is protracted (period after the cervix has dilated)
  • surgical vaginal birth (delivery involving tools such as forceps or vacuum extractor)
  • When a baby is delivered, their shoulders can become trapped.

The following are the most typical baby risk factors for neonatal seizures:

  • prematurity
  • cerebral bleeding (bleeding in the brain)
  • hypoglycemia
  • HIE, a brain disease brought on by inadequate brain oxygenation
  • metabolic conditions
  • being born with a masculine gender

What is the prognosis for infants who experience newborn seizures?

The prognosis for neonatal convulsions in infants varies depending on the underlying reason. According to research, between 18 and 25 per cent of babies who have neonatal convulsions will later acquire epilepsy. Depending on what caused the newborn seizures, the prognosis for babies with those seizures varies. 

The prognosis is favourable if a child's EEG is normal and they don't have any severe underlying illnesses. Infants with severe brain injuries or other medical problems who have had their EEGs read may, however, require lifelong care. 

More than half of all newborns who experience neonatal convulsions go on to develop chronic illnesses like cerebral palsy, postneonatal epilepsy, intellectual impairment, or a mix of these.

Neonatal convulsions can cause some babies to pass away. According to research on newborns who experienced neonatal seizures, 17% of the babies in their survey either passed away or were moved to hospice care.


Why would a newborn baby have seizures?

Hypoxic ischaemic encephalopathy, intracranial haemorrhage, intracranial infections, congenital brain abnormalities, metabolic conditions, and focal ischaemic stroke are common causes of newborn convulsions.

Do babies grow out of neonatal seizures?

Around day three of life, the convulsions start, and they typically stop within one to four months.

How serious are seizures in babies?

However, due to decreased oxygen supply to the brain and excessive brain cell activity, extended and ignored seizures can result in lasting harm.

Is seizure curable in infants?

Seizures in babies and young children can occasionally be brought on by a vitamin B6 shortage. (pyridoxine). Because the deficiency is a very manageable source of seizures, it is crucial to identify it.

Bottom line

Neonatal seizures may be an early indicator of brain damage or alterations to the brain, depending on their underlying cause. More than half of all newborns who experience prenatal convulsions have lifelong health issues. 

It might be a one-time occurrence for some kids, with no lasting effects. Depending on the underlying reason for the seizures, managing neonatal seizures may require long-term treatment for severe medical problems or the use of antiepileptic medicine.