Neonatal Seizures: Current Management and Future Challenges

Nagarajan L, ed. Neonatal Seizures: Current Management and Future Challenges. London, UK: Mac Keith Press; 2016 (214 pp). ISBN 978–1-909962–67–5

Seizures in the neonatal period reflect dysfunction of the developing brain, with numerous etiologies spanning the spectrum from genetic to acquired. Neonatal seizures differ from seizures in older children and adults in critical ways. This slim volume, part of the International Review of Child Neurology series, provides an up-to-date review of neonatal seizures, covering their definition, pathophysiology, neuroradiological correlates, detection by electrophysiological monitoring, management, and outcome. The remarkable progress in the past decade in understanding the neurobiology of the developing brain, coupled with advances in neurophysiological monitoring (and, to a lesser extent, expanded treatment options) makes this topic a timely one for such a volume.

The book provides a comprehensive overview of many important aspects of neonatal seizures. I found the chapter on the clinical approach to the neonate with seizures and the one on treatment options to be particularly valuable, and the chapter on neonatal epilepsy syndromes is notably comprehensive. There is balanced discussion about the various medications used and acknowledgment that we currently lack an ideal, age-specific, rational treatment. Neuroprotective approaches, such as therapeutic hypothermia, receive balanced consideration in several chapters. The chapters on conventional and amplitude-integrated electroencephalography (EEG) are clear and useful, providing well-reasoned indications as to when each modality is most informative. However, the chapter on automated seizure detection will be of marginal usefulness for the practicing physician. Unlike many similar publications, the EEG tracings here are crisp and easy to interpret. Many but not all of the authors are recognized authorities in the field. The book's editor wrote or coauthored 5 of the book's 12 chapters, and these are among the most clearly written. I would have liked to see more coverage of the neurobiology and neurophysiology of the developing brain, with some attempt to correlate seizure outcome with early pathophysiology, that is, how and why do neonatal seizures lead to later epilepsy (potential mechanisms of epileptogenesis).

Some of the book's shortcomings warrant mention. There are numerous, avoidable editorial errors including the consistent misspelling of the word dependent in one chapter, the repeated reference to “Sandiper” (supposed to be Sandifer) syndrome, and numerous citations in the text that do not make it to the reference list. Other misspellings are plentiful as well; while these oversights do not diminish the book's impact, they do distract the reader.

Overall, I recommend this book strongly to professionals who care for neonates with seizures, including pediatric neurologists, neonatologists, house officers in pediatrics and neurology, and neonatal nurses. It is the most contemporary and comprehensive coverage of neonatal seizures currently available in a single volume, and as such, comprises an important source of clinical information.