Seizures can be the most dramatic indication of neurologic abnormality in the newborn, yet most neonatal seizures are subtle or even silent. There are five types of neonatal seizures: subtle seizures (presenting with apnea, starring, lip smacking, chewing or eye blinking); focal clonic; multifocal clonic; tonic, and myoclonic seizures. The causes of neonatal seizures include metabolic, toxic, structural and infectious diseases.
Diagnosis: clinical
Drug Treatment:
Phenobarbital, i.m/i.v/p.o. 4-6 mg kg/day loading dose, followed by 5 mg/kg in two divided doses. (S/E, C/I and dosage forms: see page 118)
Alternative
Phenytoin, i.m/i.v/p.o. 4-6 mg kg/day loading dose, followed by 5 mg/kg in two divided doses. (S/E, C/I and dosage forms: see page 119)
If seizures are associated with,
A. Hypocalcaemia (Hypocalcaemic tetany):
Calcium gluconate solution, 10% 1-2 ml/kg/; repeat PRN after 6 hours.
S/E: bradycardia, cardiac arrest, extra vascular leakage may cause local necrosis.
Dosage forms: syrup 4gm/15ml; injection, 10% solution, 10 ml.
B. Hypoglycemia:
Glucose 10%, (For Dosage, see under Hypoglycemia, page 195)
C. Vitamin B6 deficiency:
Vitamin B6 (pyridoxine): 50mg i.m. as single dose.
Dosage form: injection, 50mg/ml in 2ml.
