Thursday, June 16, 2011

Neonatal seizures - Etiology

Incriminated in the etiology of perinatal causes of neonatal seizures include:
- Hypoxic-ischemic encephalopathy is 40% of seizure onset in the first 12-24 hours.May be associated with metabolic disorders posthipoxice (hypoglycemia, hypocalcemia, inappropriate ADH, hyponatremia). Seizures with this etiology occurs very close birth. These children have very low Apgar score meningo-cerebral hemorrhage and presents the three locations of them - periventricular, subarachnoid or subdural hematoma.- Intracranial hemorrhage is 12, 5% of seizures as a result of birth in bregmatica presentation, application of forceps. Is manifested by focal seizures occurred after the first day of life. Are frequently associated with prematurity.- Cerebral vascular malformations (17%) aneurysms, arteriovenous malformations, hydrocephalus, holoprozencefalie.- Disorders of the central nervous system development.
Metabolic disorders below may occur in newborns with seizures:- Translated by blood glucose hypoglycemia below 40 mg% in newborn SGA, premature, newborn asphyxia, Beckwith-Wideman syndrome. Usually the newborn with hypoglycemia presents hypotonia, apnea, tremors and convulsions if hypoglycemia is prolonged.- Hypocalcemia, the values ​​of calcium (Ca) serum below 7 mg / DLSI As ion in 3, 5 mg%. Seizures occur after the first week of life and are generally focal.- Hypomagnesaemia, an amount of magnesium (Mg) in 1, 2 mg%- Hyponatremia: due to inadequate secretion of antidiuretic hormone (ADH) is produced excessive renal salt loss and hyponatremia due to excessive fluid administration.- Hyponatremia caused by kidney disease, dehydration, diabetes insipidus or iatrogenic;- Piridoxindependenta;- Amino acid metabolism disorders;- Organic acidemii: acidemie methylmalonic, propionic, lactic acidosis congenital;- Fructose intolerance;- Impaired mitochondrial enzyme deficiencies;- Storage disease.
Infections cause 10% of neonatal seizures. Among these are: bacterial infections, viral infections, TORCH syndrome.
Medications administered mother or newborn
Polycythemia, generally manifested by lethargy and hypotonia, but seizures can occur.Focal infarcts with arterial occlusion or venous.Undetermined etiology of neonatal convulsions family, some may be autosomal dominant.Benign neonatal seizures are convulsions of the 5th day (healthy term infants, multifocal clonic seizures, lasting less than 24 hours).Undiagnosed seizures, idiopathic are found in a proportion of 3-25%.

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