Seizures in the newborn infant - Diagnosis, treatment, and outcome

Seizures remain one of the few neonatal neurologic emergencies that may potentially reflect significant damage to the immature brain; diagnostic and therapeutic plans should be established promptly. The limited clinical repertoire of the neonate presents a challenge to the physician's evaluation of the nervous system. Environmental restrictions further hamper the performance of a neonatal neurologic examination; confinement within an isolette of an intubated infant with multiple catheters and the use of pharmacologic agents that alter arousal and muscle tone limit the clinician's ability to elicit the full complement of clinical neurologic signs. Neurophysiologic monitoring therefore assumes an important ancillary role in the evaluation of the neonate with seizures and other suspected encephalopathies.(85,97,100)