Neonatal Seizures: Diagnosis, Etiologies, and Management

Julie Ziobro, MD, PhD; Renée A. Shellhaas, MD, MS


Semin Neurol. 2020;40(2):246-256. 

In This Article


Neonatal seizures are relatively uncommon and have potentially devastating consequences. Recognition of patients who are at a high risk of acute symptomatic neonatal seizures is essential to provide appropriate monitoring, diagnosis, and treatment of seizures and their underlying etiology. Neonatal epilepsy should be considered in patients without a clear seizure-provoking event or who do not respond as expected to usual treatments. In these patients, identification of an underlying genetic, metabolic, or structural abnormality is critical to understanding potential multisystem involvement, appropriate treatment, and likely outcomes. Neonates require special consideration when formulating a treatment plan as both seizures and their treatments have consequences for the developing brain; further research is urgently needed to validate the use of many newer ASMs in this patient population. Additional research is essential for the advancement of precision medicine for both acute symptomatic seizures and neonatal epilepsies.