Neonatal seizures

Seizures are caused by electrical discharge excessive and synchronous depolarization of neurons in the central nervous system (CNS).
Clinical appearance of seizures in young children is much different from the great child, is atypical, which will aggravate the diagnosis.Seizures are common form of grimacing rhythmic, repetitive movements of suction, seizures, apnea, shift eye position (lateral or rotary nystagmus intermittently), repetitive movements of a single member (focal seizures), generalized hypertonia with conjugate deviation of head and eyes (tonic suggesting the child aspect decerebrat).Primary symptom in the manifestation of seizures is the installation of apnea accompanied by normal or accelerated heart rate.Neonatal seizures are difficult to differentiate from other disordered movements, but harmless as can be found normally in this period such as clonus, tremor.
For diagnosis of neonatal seizures issuing route electroencephalographic recording plays an important role.
Clinical forms:
Focal clonic seizures are associated with metabolic disorders, focal brain injury (subarachnoid hemorrhage, focal infarcts). Overall prognosis is good.
Multifocal clonic seizures occur in babies under 34 weeks gestation.Electroencephalogram (EEG) has an abnormal appearance.
Tonic seizures are associated with deviations of the eye or clonic movements and apnea. Appear to prematurity or intraventricular hemorrhage. The prognosis is bad.
Myoclonic seizures are associated with diffuse lesions of the central nervous system (CNS). Prognosis of these diseases is wrong.
Subtle convulsive seizures are equivalent, a rate of 50% of seizures in term newborn and premature cortical in origin, not associated with EEG changes and improved treatment are anticonvulsant. This is manifested by:- Abnormal eye movements: on set, blinking, horizontal eye deviation;- Oral buco-pharyngeal movements: movements of suction, chewing, tongue protrusion, hypersalivation;- Abnormal limb movements: movements of pedaling, swimming, tremors, tonic posture of a member, paddling;- Apnea, usually without bradycardia, but if apnea is more than 20 seconds is bradycardia.
Malaise convulsive seizures are persistent or repetitive clinical and / or power for more than 30 minutes.
Differential Diagnosis:
Mandatory is the differentiation of seizures from tremors. Shaking associated with hypocalcemia, hypoglycemia, neonatal encephalopathy, newborn from the motherdiabetic.Shaking are accompanied by eye movements are rhythmic, equal in amplitude. Can be caused by stimulating the infant and can be stopped by passive flexion of the affected limb. Are generally accompanied by autonomous phenomena: high blood pressure, tachycardia, bradycardia. Also not associated with abnormal electroencephalogram (EEG). Repeat with 2-3/secunde rate.