Abstract
Neonates are exquisitely susceptible to seizures due to several physiologic factors
and combination of risks that are uniquely associated with gestation, delivery, and
the immediate postnatal period. Neonatal seizures can be challenging to identify;
therefore, it is imperative that clinicians have a high degree of suspicion for seizures
based on the clinical history or the presence of encephalopathy with or without paroxysmal
abnormal movements. Acute symptomatic neonatal seizures are due to an acute brain
injury, whereas neonatal-onset epilepsy may be related to underlying structural, metabolic,
or genetic disorders. Though initial, acute treatment is similar, long-term treatment
and prognosis varies greatly based on underlying seizure etiology. Early identification
and treatment are likely important for long-term outcomes in acute symptomatic seizures,
though additional studies are needed to understand optimal seizure control metrics
and the ideal duration of treatment. Advances in genetic medicine are increasingly
expanding our understanding of neonatal-onset epilepsies and will continue to open
doors for personalized medicine to optimize outcomes in this fragile population.
Keywords
epilepsy - neonate - encephalopathy - seizure
