Unexpected neurologic events in the maternity ward

Abstract

Unexpected neurologic events in the maternity ward are highly suggestive of seizure activity in the newborn infant. Acute provoked symptomatic seizures associated with an early ischaemic or haemorrhagic brain insult account for more than 70% of neonatal seizures. Neonatal onset of infantile epilepsy occurs much less often. These two pathologic entities represent different types of seizures, different semiology, and different response to anti-epileptic drugs. Recognising clinical seizures in a newborn infant can be challenging and must be confirmed with video EEG monitoring. Seizures in a healthy term neonate necessitate admission to a neonatal intensive care unit. Investigating the aetiology and providing a prognosis to the parents require special expertise, including specific laboratory testing, magnetic resonance imaging of the brain and neurophysiological analysis. The purpose of this review is to highlight the aetiology and the clinical presentation of seizures in the apparently healthy term neonate and to propose a network management algorithm between paediatricians, neonatologists, and neuro-paediatricians.