Neonatal seizures - Treatment

Optimizing ventilation (dezobstruare, oxigeno - therapy), cardiac output, blood pressure, serum electrolytes and correction of acidosis.

Treatment consists of intravenous administration of glucose - 10% bolus, 2-4 ml / kg, 0, 5-1 g / kg with continuous 5-8 ml PIV / kg / h for metabolic seizures.
Anticonvulsants may be administered: phenobarbital, phenytoin, diazepam, lorazepam, midazolam, paraldehyde

Adjuvant therapy includes administration of calcium (Ca) gluconic 5%, 4 ml / kg, sulfurmagnesium (MgSO4) 20% 0, 2 ml / kg, Pyridoxine 300mg/kgc/zi in high dose.

Treatment includes antibiotics etiological neonatal meningitis.

prognosis:

Death occurs in 15% of cases.
You can install neurological sequelae such as mental retardation, motor deficit and seizures in 30% of cases.

It finds a good evolution in 50% of cases.
Chronic seizures occupy 15-20% depending on the degree of brain maturation, theetiology of seizures, the appearance of EEG, neurological examination and imagingaspects.
EEG changes associated with neurological sequelae with an incidence of 90%suppression when there is electricity, if the 50% asymmetric waves and normal EEG, the percentage of cases that will develop sequelae is below 10%.

Neonatal seizures stop a few days after onset, even in those children with residualbrain damage. Instead, these children may manifest in infancy another type of seizuressuch as infantile spasms.
After cessation of seizures is necessary to continue maintenance treatment withphenobarbital, the oral dose of 3-4 mg / kg / day. Medication should be discontinuedwhen symptoms occur and complete disappearance of the route normalizeselectroencephalographic, no longer a risk of recurrent disease.