Tests to ascertain the cause of neonatal seizures include the following:
-
Serum glucose and electrolytes - Transient neonatal hypocalcemia is a cause of neonatal seizures during the first 3 weeks of life; hypocalcemia associated with chromosome 22q11 deletion syndrome may also be a consideration
-
TORCH (toxoplasmosis, rubella, CMV, herpes) infection studies
-
Urine organic acids
-
Serum amino acid assay
-
Renal function tests - These tests rule out posthypoxic renal dysfunction; hypoxic damage to multiple organ systems may also be suggested by elevated liver transaminase levels
-
Chromosomal microarray - Chromosomal abnormalities are often associated with neonatal encephalopathy including seizures
-
Epilepsy panel/genetic testing - Single gene mutations are frequently identified as causative of neonatal seizures, such as channels for electrolyte or glucuse transport, or genes involved in metabolism (metabolic epilepsies)
-
Onset of neonatal seizure demonstrating a focal onset in the right frontal (FP4) region. At this point, the child had head and eye deviation to the left.
-
Twenty seconds into a seizure that had focal onset in the right frontal (FP4) region, the seizure shows a rhythmic buildup of activity in the right frontocentral region.
-
This seizure had focal onset in the right frontal (FP4) region and subsequent buildup of activity in the right frontocentral region. As the seizure evolves, the electroencephalogram shows diffuse involvement of both cerebral hemispheres.
