All issues > Volume 52(9); 2009

Review Article

Korean J Pediatr. 2009;52(9):964-970. Published online September 15, 2009.

Diagnosis of neonatal seizures

Hee Jung HJ Chung¹, Yun Jung YJ Hur²

¹Department of Pediatrics, National Health Insurance Corporation, Ilsan Hospital, Goyang, Korea
²Department of Pediatrics, Cha University College of Medicine, Seoul, Korea

Correspondence Hee Jung HJ Chung ,Email: agathac@nhimc.or.kr

Abstract

Neonatal seizures are generally not only brief and subtle but also not easily recognized and are usually untreated. In sick neonates, seizures are frequently not manifested clinically but are detected only by electroencephalography (subclinical EEG seizures). This phenomenon of electroclinical dissociation is fairly common in neonates. On the other hand, neonates frequently show clinical behaviors such as stiffening, apnea, or autonomic manifestations that mimic seizures, which is usually associated with underlying encephalopathy and non-epileptic seizures. Therefore, it might be difficult to confirm the diagnosis of neonatal seizures. Early recognition of neonatal seizures is important to minimize poor neurodevelopmental outcomes, including cognitive, behavioral, and learning disabilities, as well as the development of postnatal epilepsy. EEG is a reliable tool in the determination of neonatal seizures. Continuous EEG monitoring is essential for the identification of seizures, evaluation of treatment efficacy, and prediction of the neurodevelopmental outcome. However, there is not yet a wide consensus on the optimal “standard” lead montage for the continuous EEG monitoring.

Keywords :Newborn, Seizures, Diagnosis, Electroencephalography, Subclinical seizures