Infant Seizures
Infant seizures happen when an abnormal extra burst of electrical activity occurs between neurons, or brain cells, in a baby’s brain. These can happen for many reasons.
Seizures are the most common neurological emergency in the first 4 weeks of a baby’s life. As many as 1–5 babies per 1,000 experience a seizure. Some seizures only last a few minutes and occur once, leaving no lasting damage.
When a baby experiences frequent seizures, they must receive treatment to prevent brain damage. Brain damage occurs due to the frequent disruption of brain oxygen levels and excessive brain cell activity.
Signs –
Some of the signs of infant seizures include –
• Tonic seizures: Parts (or all) of the infant’s body can stiffen suddenly.
• Myoclonic seizures: A group of muscles in the infant’s body may all start to jerk in clusters several times each day and for a few days in a row. These muscle groups are usually in the shoulders, neck, or upper arms. This is called a myoclonic seizure.
• Febrile seizures: The infant’s limbs may either stiffen or twitch and jerk, and their eyes may roll. These seizures are the most common type of infant seizures and are usually caused by a fever above 102 degrees.
• Atonic seizures: The infant may suddenly go limp and unresponsive, as in dropping their head suddenly or falling suddenly to the floor while crawling or walking.
• Absence seizure: The infant may appear to have short episodes of staring into space, blinking their eyes quickly, or moving their mouth as if chewing. This is called an absence seizure.
• Focal seizures:It may involve the infant having spasms or rigidity in one muscle group, becoming pale, sweating, vomiting, screaming, crying, gagging, smacking their lips, or becoming unconscious.
• Infantile spasm:The infant may experience spasms characterized by stiffening of the arms and legs, bending forward, and arching of the back. This rarer form of seizures usually occurs between 4-8 months of birth.
Causes –
Many different conditions and injuries can cause a baby’s seizures. A The most common cause of seizures in newborn infants is brain damage from illness or injury, such as hypoxic-ischemic encephalopathy (HIE).
Other causes include –
• Viral and bacterial infections
Viral encephalitis causes brain inflammation and seizures. Common viruses, such as the flu, can cause a baby’s temperature to rise, increasing their risk of a febrile seizure. Bacterial infections, in particular, Group B strep bacteria can cause meningitis in babies, which can present with seizures.
• Febrile seizures
Sometimes babies that have a fever or high body temperature may develop a febrile seizure. They typically only last a few minutes and occur most often in young children, roughly between 6 months and 5 years.
• Hydrocephalus from brain injury
When a baby has hydrocephalus, cerebrospinal fluid (CSF) applies pressure on the brain. It is a common condition and can also occur on its own in the womb. If a doctor uses forceps or vacuum extractors to help deliver the baby, this may injure the head and cause CSF to accumulate on the brain.
• Cerebral palsy
Seizures are a common symptom of cerebral palsy. If a baby has cerebral palsy, they will find it difficult to control muscle.
Some other causes are –
• Brain bleed or hemorrhage
• Stroke
• Brain tumor
• Low blood sugar
Diagnosis –
A test called an electroencephalogram (EEG) is essential for diagnosing and managing neonatal seizures. EEG records the electrical activity of the brain, and abnormalities on an EEG test (measured between seizures) can indicate a risk for seizures. However, babies with benign familial neonatal seizures usually have normal EEG readings.
Imaging tests of the brain, including magnetic resonance imaging (MRI) and computed tomography (CT) scan, are also used to determine the cause of seizures.
Treatment –
If necessary, doctors may control seizures in babies with anticonvulsant medication, including:
• phenobarbital
• phenytoin
• zonisamide
If the seizures are due to a lack of oxygen, doctors may administer hypothermic treatment. This procedure cools the baby’s brain and body to prevent brain damage. They may do this if a baby experiences difficulties during birth and is not able to breathe.
Some babies may need long-term treatment to prevent seizures from recurring. A doctor needs to know the exact cause of the seizures before prescribing an effective treatment plan. For example, treatment will differ if a baby has epilepsy or is recovering from meningitis.
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