Children's Hospital of Michigan

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Children's Hospital of Michigan Neonatal Seizures Eishi Asano, MD, PhD, MS Associate Professor of Pediatrics and Neurology Wayne State University School of Medicine Director, Electroneurodiagnostic Lab Children's Hospital of Michigan

In childhood, the risk of seizures is highest in the neonatal period (1.8 to 3.5/1000 live births in the United States). Is this description true?

Yes.

Neonatal seizures are associated with high mortality and morbidity rates, and their ultimate outcome is strongly influenced by their underlying cause (rather than EEG findings or type of antiepileptic treatment). Is this description true?

Yes, Underlying etiology >> EEG findings Data from both human and animal studies suggest that seizures amplify neonatal hypoxic-ischemic brain damage.

When you read neonatal EEG, which of the followings are very important and must be included into the report? (1) Age (2) State (3) Background (4) Interictal spike discharges (5) Neonatal seizures

Subclinical seizures are common in several NICU populations, including severely asphyxiated infants and preterm infants with development of intraventricular hemorrhage. Clinical correlates occur in 20% to 80% of EEG studies in neonates, and in the busy NICU setting, clinical seizure recognition may be even lower than that estimated from the review of EEG data. Is this description true?

Yes. Thus, some investigators emphasize the importance of video-EEG in infants suspected of neonatal seizures.

A 41-week-CA neonate (33 + 8 weeks) Is it a part of seizure? Fp3-T3 T3-O1 Fp3-C3 C3-O1 Fp4-T4 T4-O2 Fp4-C4 C4-O2 A1-T3 T3-C3 C3-Cz Cz-C4 C4-T4 T4-A2 LOC ROC EMG EKG RESP

Yes

Is it a part of seizure?

How about this?

Brain & Development 30 (2008) 261–268

How about this?

Neonatal seizure. Clin Neurophysiol 2007;118:2156-61

Is it a part of seizure?

Yes Clinical Neurophysiology 119 (2008) 1248–1261

Is it a part of seizure?

Yes, this seizure consisted of unilateral, occipital, slow, sharp wave activity. Pediatrics. 2008 Jun;121(6):1146-54.

Is it a part of seizure?

Yes. Focal ictal discharge beginning in the right occipital region. The EEG background activity is low voltage. This EEG is from a preterm infant, born at 30 weeks GA with Listeria meningitis. Calibration 1 s and 70 lV. F. Pisani et al. / Brain & Development 30 (2008) 20–30

Is it a part of seizure?

No. These were thought to be related to electrode, patting, and muscle artifact Pediatrics. 2008 Jun;121(6):1146-54.

Is it a part of seizure?

No. These were thought to be related to electrode, patting, and muscle artifact Pediatrics. 2008 Jun;121(6):1146-54.

Is it a part of seizure?

No. These were thought to be related to electrode, patting, and muscle artifact Pediatrics. 2008 Jun;121(6):1146-54.

Benign Neonatal Epilepsy

? Benign neonatal epilepsy is an autosomal dominant disorder characterized by clusters of seizures occurring in the first days of life.

Benign neonatal epilepsy is an autosomal dominant disorder characterized by clusters of seizures occurring in the first days of life. Most patients have spontaneous remission by 12 months of age.

Underlying mutations?

KCNQ2 gene 20q KCNQ3 gene 8q K is what K?

M-type potassium channels

KCNQ2 gene 20q KCNQ3 gene 8q Such mutations are specific to benign neonatal epilepsy?