Neonatal seizure

A neonatal seizure is a seizure occurring in an infant younger than four weeks old, confirmed by abnormal electrical activity recorded on an electroencephalogram. It can appear as stiffening or jerking of the limbs, unusual eye movements or lip-smacking, and may also change the infant heart rate, blood pressure or breathing; most cases arise from an underlying cause rather than primary epilepsy, with oxygen deprivation during birth, known as hypoxic-ischemic encephalopathy, the leading cause in full-term infants, and bleeding inside the brain ventricles the most common cause in premature infants. Neonatal seizures affect an estimated 1 to 3.5 of every 1,000 births, making them the most common neurological problem seen in newborn nurseries, though many are subclinical and cannot be diagnosed by observation alone, so an EEG is required to confirm the diagnosis, and treatment, guided by the underlying cause, typically starts with an anti-epileptic drug such as phenobarbital.