0 Neonatal Seizures

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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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