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43 - Neonatal seizures: an expression of fetal or neonatal brain disorders

from Section 5 - Management of the depressed or neurologically dysfunctional neonate

Published online by Cambridge University Press:  12 January 2010

By
Mark S. Scher
Edited by
David K. Stevenson ,
William E. Benitz ,
Philip Sunshine ,
Susan R. Hintz  and
Maurice L. Druzin
David K. Stevenson
Affiliation:
Stanford University School of Medicine, California
William E. Benitz
Affiliation:
Stanford University School of Medicine, California
Philip Sunshine
Affiliation:
Stanford University School of Medicine, California
Susan R. Hintz
Affiliation:
Stanford University School of Medicine, California
Maurice L. Druzin
Affiliation:
Stanford University School of Medicine, California
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Summary

Introduction

Neonatal seizures are one of the few neonatal neurological conditions that require immediate medical attention. While prompt diagnostic and therapeutic plans are needed, multiple challenges impede the physician's evaluation of the newborn with suspected clinical and electroencephalographic (EEG) manifestations of neonatal seizures, which vary dramatically from those in older children. Recognition of the seizure state remains the foremost challenge to overcome. This dilemma is underscored by the brevity and subtlety of the clinical repertoire of the neonatal neurological examination.

Basic issues still remain regarding the recognition and treatment of neonatal seizures (Table 43.1). Which newborns with seizures to treat, and how to treat them, continues to occupy much discussion and controversy in written and oral presentations. While clinical seizures remain a common occurrence in neonatal intensive care settings, with an incidence as high as 2.6/1000 live births for term infants and 30–130/1000 live preterm births, increasing use of bedside EEG monitoring has resulted in the growing recognition that the incidence of seizures may be even higher. Yet the “who” question in the algorithm to diagnose and treat neonatal seizures includes a heterogeneous cohort of newborns who may present throughout the neonatal period (i.e., 30 days post-term). The manner of clinical presentation will reflect alternative diagnostic explanations for seizure recurrence based on timing, etiology, or brain region of injury. Presentation may imply part of a longer-standing encephalopathic process prior to and/or during parturition in some newborns.

Type
Chapter
Information
Fetal and Neonatal Brain Injury , pp. 499 - 526
Publisher: Cambridge University Press
Print publication year: 2009

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References

Scher, MS. Seizures in the neonate: diagnostic and therapeutic considerations. In Spitzer, AR, ed., Intensive Care of the Fetus and Neonate, 2nd edn. Philadelphia, PA: Saunders, 2004.Google Scholar
Scher, MS. Neonatal seizures: an expression of fetal or neonatal brain disorders. In Stevenson, DK, Benitz WE, Sunshine, P, eds., Fetal and Neonatal Brain Injury, 3rd edn. Cambridge: Cambridge University Press, 2002: 735–84.Google Scholar
Clancy, RR. Prolonged electroencephalogram monitoring for seizures and their treatment. Clin Perinatol 2006; 33: 649–65.CrossRefGoogle ScholarPubMed
Proposal for revised clinical and electroencephalographic classification of epileptic seizures. From the Commission on Classification and Terminology of the International League Against Epilepsy. Epilepsia 1981; 22: 489–501.
Mizrahi, EM, Kellaway, P. Diagnosis and Management of Neonatal Seizures. Philadelphia, PA: Lippincott-Raven, 1998.Google Scholar
Weiner, SP, Painter, MJ, Geva, D, et al. Neonatal seizures: electroclinical dissociation. Pediatr Neurol 1991; 7: 363–8.CrossRefGoogle ScholarPubMed
Biagioni, E, Ferrari, F, Boldrini, A, et al. Electroclinical correlation in neonatal seizures. Eur J Paediatr Neurol 1998; 2: 117–25.CrossRefGoogle ScholarPubMed
Volpe, JJ. Neonatal seizures. In Neurology of the Newborn, 4th edn. Philadelphia, PA: Saunders. 2001: 178–214.Google Scholar
Scher, MS. Electroencephalography of the newborn: normal and abnormal features. In Niedermeyer, E, Lopes da Silva, F, eds., Electroencephalography: Basic Principles, Clinical Applications, and Related Fields, 5th edn. Philadelphia, PA: Lippincott Williams and Wilkins, 2005: 937–89.Google Scholar
Scher, MS. Normal electrographic–polysomnographic patterns in preterm and fullterm infants. Semin Pediatr Neurol 1996; 3: 2–12.CrossRefGoogle ScholarPubMed
DaSilva, O, Guzman, GMC, Young, GB. The value of standard electroencephalograms in the evaluation of the newborn with recurrent apneas. J Perinatol 1998; 18: 377–80.Google Scholar
Fenichel, GM, Olson, BJ, Fitzpatrick, JE. Heart rate changes in convulsive and nonconvulsive neonatal apnea. Ann Neurol 1980; 7: 577–82.CrossRefGoogle ScholarPubMed
Bye, AM, Flanagan, D. Spatial and temporal characteristics of neonatal seizures. Epilepsia 1995; 36: 1009–16.CrossRefGoogle ScholarPubMed
Boylan, GB, Pressler, RM, Rennie, JM, et al. Outcome of electroclinical, electrographic, and clinical seizures in the newborn infant. Dev Med Child Neurol 1999; 41: 819–25.CrossRefGoogle ScholarPubMed
Mizrahi, EM, Kellaway, P. Characterization and classification of neonatal seizures. Neurology 1987; 37: 1837–44.CrossRefGoogle ScholarPubMed
Scher, MS, Klesh, KW, Murphy, TF, et al. Seizures and infarction in neonates with persistent pulmonary hypertension. Pediatr Neurol 1986; 2: 332–9.CrossRefGoogle ScholarPubMed
Clancy, R, Malin, S, Laraque, D, et al. Focal motor seizures heralding stroke in full-term neonates. Am J Dis Child 1985; 139: 601–6.Google ScholarPubMed
Levy, SR, Abroms, IF, Marshall, PC, et al. Seizures and cerebral infarction in the full-term newborn. Ann Neurol 1985; 17: 366–70.CrossRefGoogle ScholarPubMed
Holmes, G. Diagnosis and management of seizures in childhood. In Markowitz, M, ed., Major Problems in Clinical Pediatrics. Philadelphia, PA: Saunders, 1987: 237–61.Google Scholar
Karayiannis, NB, Srinivasan, S, Bhattacharya, R, et al. Extraction of motion strength and motor activity signals from video recordings of neonatal seizures. IEEE Trans Med Imaging 2001; 20: 965–80.CrossRefGoogle ScholarPubMed
Rose, AL, Lombroso, CT. A study of clinical, pathological, and electroencephalographic features in 137 full-term babies with a long-term follow-up. Pediatrics 1970; 45: 404–25.Google ScholarPubMed
Kellaway, P, Hrachovy, RA. Status epilepticus in newborns: a perspective on neonatal seizures. In Delgado-Escueta, AV, Wasterlain, CG, Treiman, DM, et al., eds., Status Epilepticus: Mechanisms of Brain Damage and Treatment. New York, NY: Raven Press, 1983: 93–9.Google Scholar
Sarnat, HB. Anatomic and physiologic correlates of neurologic development in prematurity. In Sarnat, HB, ed., Topics in Neonatal Neurology. Orlando, FL: Grune and Stratton, 1984: 1–25.Google Scholar
Scher, MS. Pathologic myoclonus of the newborn: electrographic and clinical correlations. Pediatr Neurol 1985; 1: 342–8.CrossRefGoogle ScholarPubMed
Coulter, DL, Allen, RJ. Benign neonatal sleep myoclonus. Arch Neurol 1982; 39: 191–2.CrossRefGoogle ScholarPubMed
Resnick, TJ, Moshe, SL, Perotta, L, et al. Benign neonatal sleep myoclonus: relationship to sleep states. Arch Neurol 1986; 43: 266–8.CrossRefGoogle ScholarPubMed
Clancy, RR. The contribution of EEG to the understanding of neonatal seizures. Epilepsia 1996; 37: S52–9.CrossRefGoogle ScholarPubMed
Shuper, A, Zalzberg, J, Weitz, R, et al. Jitteriness beyond the neonatal period: a benign pattern of movement in infancy. J Child Neurol 1991; 6: 243–5.CrossRefGoogle ScholarPubMed
Parker, S, Zuckerman, B, Bauchner, H, et al. Jitteriness in full-term neonates: prevalence and correlates. Pediatrics 1990; 85: 17–23.Google ScholarPubMed
Hakamada, S, Watanabe, K, Hara, K, et al. Development of the motor behavior during sleep in newborn infants. Brain Dev 1981; 3: 345–50.CrossRefGoogle ScholarPubMed
Scher, MS, Belfar, H, Martin, J, et al. Destructive brain lesions of presumed fetal onset: antepartum causes of cerebral palsy. Pediatrics 1991; 88: 898–906.Google ScholarPubMed
Sexson, WR, Thigpen, J, Stajich, GV. Stereotypic movements after lorazepam administration in premature neonates: a series and review of the literature. J Perinatol 1995; 15: 146–51.Google ScholarPubMed
Brown, P, Rothwell, JC, Thompson, PD, et al. The hyperekplexias and their relationship to the normal startle reflex. Brain 1991; 114: 1903–28.CrossRefGoogle ScholarPubMed
Andermann, F, Andermann, E. Startle disorders of man: hyperekplexia, jumping and startle epilepsy. Brain Dev 1988; 10: 213–22.CrossRefGoogle ScholarPubMed
Barth, PJ. Inherited progressive disorders of the fetal brain: a field in need of recognition. In Fukuyama, Y, Suzuki, Y, Kamoshia, S, et al., eds., Fetal and Perinatal Neurology. New York, NY: Karger, 1992: 299–313.Google Scholar
Lyon, G, Adams, RD, Kolodny, EH. Hypoglycemia. In Neurology of Hereditary Metabolic Diseases of Children, 2nd edn. New York, NY: McGraw-Hill, 1996: 6–44.Google Scholar
Scher, MS. Seizures in the newborn infant: diagnosis, treatment, and outcome. Clin Perinatol 1997; 24: 735–72.CrossRefGoogle Scholar
Oliveira, AJ, Nunes, ML, da Costa, JC. Polysomnography in neonatal seizures. Clin Neurophysiol 2000; 111: S74–80.CrossRefGoogle ScholarPubMed
Watanabe, K, Kuroyanagi, M, Hara, K, et al. Neonatal seizures and subsequent epilepsy. Brain Dev 1982; 4: 341–6.CrossRefGoogle ScholarPubMed
Hrachovy, R, Mizrahi, E, Kellaway, P. Electroencephalography of the newborn. In Daly, D, Pedley, T, eds., Current Practice of Clinical Electroencephalography, 2nd edn. New York, NY: Raven Press, 1990: 201–42.Google Scholar
Stockard-Pope, JE, Werner, SS, Bickford, RG. Atlas of Neonatal Electroencephalography, 2nd edn. New York, NY: Raven Press, 1992.Google Scholar
Lombroso, CT. Neonatal polygraphy in full-term and premature infants: a review of normal and abnormal findings. J Clin Neurophysiol 1985; 2: 105–55.CrossRefGoogle ScholarPubMed
Hellstrom-Westas, L. Comparison between tape-recorded and amplitude-integrated EEG monitoring in sick newborn infants. Acta Paediatr 1992; 81: 812–9.CrossRefGoogle ScholarPubMed
Klebermass, K, Kuhle, S, Kohlhauser-Vollmuth, C, et al. Evaluation of the Cerebral Function Monitor as a tool for neurophysiological surveillance in neonatal intensive care patients. Childs Nerv Syst 2001; 17: 544–50.Google ScholarPubMed
Alfonso, I, Jayakar, P, Yelin, K, et al. Continuous-display four-channel electroencephalographic monitoring in the evaluation of neonates with paroxysmal motor events. J Child Neurol 2001; 16: 625–8.CrossRefGoogle ScholarPubMed
Scher, MS, Hamid, MY, Steppe, DA, et al. Ictal and interictal electrographic seizure durations in preterm and term neonates. Epilepsia 1993; 34: 284–8.CrossRefGoogle ScholarPubMed
Clancy, RR, Legido, A. The exact ictal and interictal duration of electroencephalographic neonatal seizures. Epilepsia 1987; 28: 537–41.CrossRefGoogle ScholarPubMed
Sheth, RD. Electroencephalogram confirmatory rate in neonatal seizures. Pediatr Neurol 1999; 20: 27–30.CrossRefGoogle ScholarPubMed
Painter, MJ, Scher, MS, Stein, AD, et al. Phenobarbital compared with phenytoin for the treatment of neonatal seizures. N Engl J Med 1999; 341: 485–9.CrossRefGoogle ScholarPubMed
Scher, MS, Steppe, DA, Beggarly, M. Timing of neonatal seizures and intrapartum obstetrical factors. J Child Neurol 2008; 23: 640–3.CrossRefGoogle ScholarPubMed
Scher, MS, Alvin, J, Gaus, L, et al. Uncoupling of EEG-clinical neonatal seizures after antiepileptic drug use. Pediatr Neurol 2003; 28: 277–80.CrossRefGoogle ScholarPubMed
Veliskova, J, Miller, AM, Lunes, ML, et al. Regional neural activity within the substantia nigra during peri-ictal flurothyl generalized seizure stages. Neurobiol Dis 2005; 20: 752–9.CrossRefGoogle ScholarPubMed
Merrill, MA, Clough, RW, Dailey, JW, et al. Localization of the serotonergic terminal fields modulating seizures in the genetically epilepsy-prone rat. Epilepsy Res 2007; 76: 93–102.CrossRefGoogle ScholarPubMed
Alfonso, I, Papazian, O, Litt, R, et al. Single photon emission computed tomographic evaluation of brainstem release phenomenon and seizure in neonates. J Child Neurol 2000; 15: 56–8.CrossRefGoogle ScholarPubMed
Kilic, S, Tarim, O, Eralp, O. Serum prolactin in neonatal seizures. Pediatr Int 1999; 41: 61–4.Google ScholarPubMed
Browning, RA. Role of the brain-stem reticular formation in tonic–clonic seizures: lesion and pharmacological studies. Fed Proc 1985; 44: 2425–31.Google ScholarPubMed
Caveness, WF, Kato, M, Malamut, BL, et al. Propagation of focal motor seizures in the pubescent monkey. Ann Neurol 1980; 7: 213–21, 232–5.CrossRefGoogle ScholarPubMed
Hosokawa, S, Iguchi, T, Caveness, WF, et al. Effects of manipulation of the sensorimotor system on focal motor seizures in the monkey. Ann Neurol 1980; 7: 222–9, 236–7.CrossRefGoogle ScholarPubMed
Danner, R, Shewmon, DA, Sherman, MP. Seizures in an atelencephalic infant: is the cortex essential for neonatal seizures?Arch Neurol 1985; 42: 1014–16.CrossRefGoogle Scholar
,Subcortical Control of Cortical Excitability, Plenary Session. American Epilepsy Society Meeting, Philadelphia, PA, December, 2005.
Scher, MS, Aso, K, Beggarly, ME, et al. Electrographic seizures in preterm and full-term neonates: clinical correlates, associated brain lesions, and risk for neurologic sequelae. Pediatrics 1993; 91: 128–34.Google ScholarPubMed
Coen, RW, McCutchen, CB, Wermer, D, et al. Continuous monitoring of the electroencephalogram following perinatal asphyxia. J Pediatr 1982; 100: 628–30.CrossRefGoogle ScholarPubMed
O'Meara, MW, Bye, AM, Flanagan, D. Clinical features of neonatal seizures. J Paediatr Child Health 1995; 31: 237–40.CrossRefGoogle ScholarPubMed
Staudt, F, Roth, JG, Engel, RC. The usefulness of electroencephalography in curarized newborns. Electroencephalogr Clin Neurophysiol 1981; 51: 205–8.CrossRefGoogle ScholarPubMed
Eyre, JA, Oozeer, RC, Wilkinson, AR. Continuous electroencephalographic recording to detect seizures in paralyzed newborn babies. Br Med J 1983; 286: 1017–18.CrossRefGoogle Scholar
Goldberg, RN, Goldman, SL, Ramsay, RE, et al. Detection of seizure activity in the paralyzed neonate using continuous monitoring. Pediatrics 1982; 69: 583–6.Google ScholarPubMed
Ronen, GM, Penney, S, Andrews, W. The epidemiology of clinical neonatal seizures in Newfoundland: a population-based study. J Pediatr 1999; 134: 71–5.CrossRefGoogle ScholarPubMed
Eriksson, M, Zetterstrom, R. Neonatal convulsions: incidence and causes in the Stockholm area. Acta Paediatr Scand 1979; 68: 807–11.CrossRefGoogle ScholarPubMed
Seay, AR, Bray, PF. Significance of seizures in infants weighing less than 2,500 grams. Arch Neurol 1977; 34: 381–2.CrossRefGoogle ScholarPubMed
Saliba, RM, Annegers, FJ, Waller, DK, et al. Risk factors for neonatal seizures: a population-based study, Harris County, Texas, 1992–1994. Am J Epidemiol 2001; 154: 14–20.CrossRefGoogle ScholarPubMed
Lanska, MJ, Lanska, DJ, Baumann, RJ, et al. Interobserver variability in the classification of neonatal seizures based on medical record data. Pediatr Neurol 1996; 15: 120–3.CrossRefGoogle ScholarPubMed
Lanska, MJ, Lanska, DJ, Baumann, RJ, et al. A population-based study of neonatal seizures in Fayette County, Kentucky. Neurology 1995; 45: 724–32.CrossRefGoogle ScholarPubMed
Patterson, CA, Graves, WL, Bugg, G, et al. Antenatal and intrapartum factors associated with the occurrence of seizures in the term infant. Obstet Gynecol 1989; 74: 361–5.Google ScholarPubMed
Bergman, I, Painter, MJ, Hirsh, RP, et al. Outcome in neonates with convulsions treated in an intensive care unit. Ann Neurol 1983; 14: 642–7.CrossRefGoogle Scholar
Evard, P, Kadhim, HJ, Saint-George, P, et al. Abnormal development and destructive processes of the human brain during the second half of gestation. In Evans, P, Minkowski, A, eds., Developmental Neurobiology. New York, NY: Raven Press, 1989: 21–39.Google Scholar
Lieberman, E, Eichenwald, E, Mathur, G, et al. Intrapartum fever and unexplained seizures in term infants. Pediatrics 2000; 106: 983–8.CrossRefGoogle ScholarPubMed
Scher, MS. Fetal neurologic consultations. Pediatr Neurol 2003; 29: 193–202.CrossRefGoogle ScholarPubMed
,American College of Obstetricians and Gynecologists and American Academy of Pediatrics. Neonatal Encephalopathy in Cerebral Palsy: Defining the Pathogenesis and Pathophysiology. Washington, DC: ACOG, 2003.
Parent, JM. The role of seizure-induced neurogenesis in epileptogenesis and brain repair. Epilepsy Res 2002; 50: 179–89.CrossRefGoogle ScholarPubMed
Swann, JW. The effects of seizures on the connectivity and circuitry of the developing brain. Ment Retard Dev Disabil Res Rev 2004; 10: 96–100.CrossRefGoogle ScholarPubMed
Eriksson, SH, Malmgren, K, Nordborg, C. Microdysgenesis in epilepsy. Acta Neurol Scand 2005; 111: 279–90.CrossRefGoogle ScholarPubMed
Squier, M, Keeling, JW. The incidence of prenatal brain injury. Neuropathol Appl Neurobiol 1991; 17: 29–38.CrossRefGoogle ScholarPubMed
Scher, MS. Neonatal seizure classification: a fetal perspective concerning childhood epilepsy. Epilepsy Res 2006; 70: S41–57.CrossRefGoogle ScholarPubMed
Scher, MS, Trucco, J, Beggarly, ME, et al. Neonates with electrically confirmed seizures and possible placental associations. Pediatr Neurol 1998; 19: 37–41.CrossRefGoogle ScholarPubMed
Friede, RL. Porencephaly, hydranencephaly, multilocular cystic encephalopathy. In Developmental Neuropathology. New York, NY: Springer-Verlag, 1975: 102–13.CrossRefGoogle Scholar
Miller, V. Neonatal cerebral infarction. Semin Pediatr Neurol 2001; 7: 278–88.CrossRefGoogle Scholar
Vries, LS, Groenendaal, F, Eken, P, et al. Infarcts in the vascular distribution of the middle cerebral artery in preterm and fullterm infants. Neuropediatrics 1997; 28: 88–96.CrossRefGoogle ScholarPubMed
Baergen, RN. The placenta as witness. Clin Perinatol 2007; 34: 393–407.CrossRefGoogle ScholarPubMed
Leth, H, Toft, PB, Herning, M, et al. Neonatal seizures associated with cerebral lesions shown by magnetic resonance imaging. Arch Dis Child Fetal Neonatal Ed 1997; 77: F105–10.CrossRefGoogle ScholarPubMed
Rutherford, M, Ward, P, Allsop, J, et al. Magnetic resonance imaging in neonatal encephalopathy. Early Hum Dev 2004; 81: 13–25.CrossRefGoogle ScholarPubMed
Enns, GM. Inborn errors of metabolism masquerading as hypoxic–ischemic encephalopathy. NeoReviews 2005; 6: e549–58.CrossRefGoogle Scholar
Scher, MS, Painter, MJ. Controversies concerning neonatal seizures. Pediatr Clin North Am 1989; 36: 281–310.CrossRefGoogle ScholarPubMed
Clancy, RR, Legido, A. Postnatal epilepsy after EEG-confirmed neonatal seizures. Epilepsia 1991; 32: 69–76.CrossRefGoogle ScholarPubMed
Temple, CM, Dennis, J, Carney, R, et al. Neonatal seizures: long-term outcome and cognitive development among “normal” survivors. Dev Med Child Neurol 1995; 37: 109–18.CrossRefGoogle ScholarPubMed
Holmes, GL, Ben-Ari, Y. The neurobiology and consequences of epilepsy in the developing brain. Pediatr Res 2001; 49: 320–5.CrossRefGoogle ScholarPubMed
Monod, N, Pajot, N, Guidasci, S. The neonatal EEG: statistical studies and prognostic value in full-term and preterm babies. Electroencephalogr Clin Neurophysiol 1972; 32: 529–44.CrossRefGoogle Scholar
Tharp, BR, Cukier, F, Monod, N. The prognostic value of the electroencephalogram in premature infants. Electroencephalogr Clin Neurophysiol 1981; 51: 219.CrossRefGoogle ScholarPubMed
McBride, M, Laroia, N, Guillet, R. Electrographic seizures in neonates correlate with poor neurodevelopmental outcome. Neurology 2002; 55: 506–13.CrossRefGoogle Scholar
Hellström-Westas, L. Comparison between tape-recorded and amplitude-integrated EEG monitoring in sick newborn infants. Acta Paediatr 1992; 81: 812–19.CrossRefGoogle ScholarPubMed
Watanabe, K, Kuroyanagi, M, Hara, K, et al. Neonatal seizures and subsequent epilepsy. Brain Dev 1982; 4: 341–6.CrossRefGoogle ScholarPubMed
Holden, KR, Mellits, ED, Freeman, JM. Neonatal seizures. I: Correlation of prenatal and perinatal events with outcomes. Pediatrics 1982; 70: 165–76.Google ScholarPubMed
Scher, MS, Aso, K, Beggarley, ME, et al. Electrographic seizures in preterm and full-term neonates: clinical correlates, associated brain lesions, and risk for neurological sequelae. Pediatrics 1993; 91: 128–34.Google Scholar
Carmo, KB, Barr, P. Drug treatment of neonatal seizures by neonatologists and pediatric neurologists. J Paediatr Child Health 2005; 41: 313–16.CrossRefGoogle Scholar
Sankar, R, Painter, MJ. Neonatal seizures: after all these years we still love what doesn't work. Neurology 2005; 64: 776–7.CrossRefGoogle ScholarPubMed
Lockman, , Kriel, R, Zaske, D, et al. Phenobarbital dosage for control of neonatal seizures. Neurology 1979; 29: 1445–9.CrossRefGoogle ScholarPubMed
Painter, MJ, Pippenger, C, MacDonald, H, et al. Phenobarbital and diphenylhydantoin levels in neonates with seizures. J Pediatr 1978; 92: 315–19.CrossRefGoogle ScholarPubMed
Painter, MJ, Pippenger, C, Wasterlain, C, et al. Phenobarbital and phenytoin in neonatal seizures: metabolism and tissue distribution. Neurology 1981; 31: 1107–12.CrossRefGoogle ScholarPubMed
Smith, BT, Masotti, RE. Intravenous diazepam in the treatment of prolonged seizure activity in neonates and infants. Dev Med Child Neurol 1971; 13: 630–4.CrossRefGoogle ScholarPubMed
Malingre, MM, Rooij, LG, Rademaker, CM, et al. Development of an optimal lidocaine infusion strategy for neonatal seizures. Eur J Pediatr 2006; 165: 598–604.CrossRefGoogle ScholarPubMed
Gal, P, Toback, J, Boer, HR, et al. Efficacy of phenobarbital monotherapy in treatment of neonatal seizures – relationship to blood levels. Neurology 1982; 32: 1401–4.CrossRefGoogle ScholarPubMed
Hall, RT, Hall, FK, Daily, DK. High-dose phenobarbital therapy in term newborn infants with severe perinatal asphyxia: a randomized, prospective study with three-year follow-up. J Pediatr 1998; 132: 345–8.CrossRefGoogle ScholarPubMed
Painter, MJ, Minnigh, B, Mollica, L, et al. Binding profiles of anticonvulsants in neonates with seizures. Ann Neurol 1987; 22: 413.Google Scholar
Montenegro, MA, Guerreiro, MM, Caldas, JP, et al. Epileptic manifestations induced by midazolam in the neonatal period. Arq Neuropsiquiatr 2001; 59: 242–3.CrossRefGoogle ScholarPubMed
Camfield, PR, Camfield, CS. Neonatal seizures: a commentary on selected aspects. J Child Neurol 1987; 2: 244–51.CrossRefGoogle ScholarPubMed
Hellstrom-Westas, L, Blennow, G, Lindroth, M, et al. Low risk of seizure recurrence after early withdrawal of antiepileptic treatment in the neonatal period. Arch Dis Child Fetal Neonatal Ed 1995; 72: F97–101.CrossRefGoogle ScholarPubMed
Mizrahi, EM. Acute and chronic effects of seizures in the developing brain: lessons from clinical experience. Epilepsia 1999; 40: S42–50, S64–6.CrossRefGoogle ScholarPubMed
Sanchez, RM, Jensen, FE. Maturational aspects of epilepsy mechanisms and consequences for the immature brain. Epilepsia 2001; 42: 577–85.CrossRefGoogle ScholarPubMed
Koh, S, Jensen, FE. Topiramate blocks perinatal hypoxia-induced seizures in rat pups. Ann Neurol 2001; 50: 366–72.CrossRefGoogle ScholarPubMed
Jensen, FE, Wang, C. Hypoxia-induced hyperexcitability in vivo and in vitro in the immature hippocampus. Epilepsy Res 1996; 26: 131–40.CrossRefGoogle ScholarPubMed
Aronica, EM, Gorter, JA, Paupard, MC, et al. Status epilepticus-induced alterations in metabotropic glutamate receptor expression in young and adult rats. J Neurosci 1997; 17: 8588–95.CrossRefGoogle Scholar
Lie, AA, Becker, A, Behle, K, et al. Up-regulation of the metabotropic glutamate receptor mGluR4 in hippocampal neurons with reduced seizure vulnerability. Ann Neurol 2000; 47: 26–35.3.0.CO;2-P>CrossRefGoogle ScholarPubMed
Brooks-Kayal, AR. Rearranging receptors. Epilepsia 2005; 46: 29–38.CrossRefGoogle ScholarPubMed
Staley, KJ. Wrong-way chloride transport: is it a treatable cause of some intractable seizures?Epilepsy Curr 2006; 6: 124–7.CrossRefGoogle ScholarPubMed
Dzhala, VI, Talos, DM, Sdrulla, DA, et al. NKCC1 transporter facilitates seizures in the developing brain. Nat Med 2005; 11: 1205–13.CrossRefGoogle ScholarPubMed
Haglund, MM, Hochman, DW. Furosemide and mannitol suppression of epileptic activity in the human brain. J Neurophysiol 2005; 94: 907–18.CrossRefGoogle ScholarPubMed
Scher, MS. Neonatal seizures and brain damage. Pediatr Neurol 2003; 29: 381–90.CrossRefGoogle ScholarPubMed
Scher, MS. Neonatal seizure classification: a fetal perspective concerning childhood epilepsy. Epilepsy Res 2006; 70: S41–57.CrossRefGoogle ScholarPubMed

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