Neonatal Seizures in Low- and Middle-Income Countries: A Review of the Literature and Recommendations for the Management

Abstract

Neonatal seizures are a common cause of neonatal intensive care unit (NICU) admission and a significant source of morbidity and mortality worldwide. Over the recent decades, there have been significant improvements in perinatal and neonatal medicine and electroencephalographic monitoring that have enhanced the diagnosis and treatment of neonatal seizures in high-income countries. However, the management of neonatal seizures remains a major challenge in low- to middle-income countries, where the availabilityof resources is limited. The purpose of this article is to present a comprehensive review of the current evidence on the etiology, pathophysiology, diagnosis, and treatment of neonatal seizures and to offer practical management recommendations that could be implemented in resource-limited settings.

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“…This uncertainty persists due to the current lack of reports in this area. In our case study, the full-term infant exhibited mild myoclonic jerks of the limbs, with each episode lasting from approximately 10-30 s. Therefore, in our case of convulsions caused by acute severe hyponatremia, the clinical type of seizure is identified as myoclonic seizures (sudden, brief, irregular limb contractions) (Pressler et al, 2021;Yozawitz, 2023;Spenard et al, 2024). The aEEG with concurrent continuous video monitoring confirmed the presence of seizures (Figure 1B).…”

“…Clinically, seizures manifest in five primary forms: 1) motor, encompassing automatism, clonic, epileptic spasm, myoclonic, and tonic; 2) nonmotor, which includes autonomic and behavior arrest; 3) sequential; 4) electroencephalographic only; and 5) unclassified (Pressler et al, 2021;Spenard et al, 2024). A systematic review indicates a notable association between specific clinical seizure types and their underlying etiologies.…”

Case report: Acute severe hyponatremia-induced seizures in a newborn: a community-acquired case and literature review

“…This uncertainty persists due to the current lack of reports in this area. In our case study, the full-term infant exhibited mild myoclonic jerks of the limbs, with each episode lasting from approximately 10–30 s. Therefore, in our case of convulsions caused by acute severe hyponatremia, the clinical type of seizure is identified as myoclonic seizures (sudden, brief, irregular limb contractions) ( Pressler et al, 2021 ; Yozawitz, 2023 ; Spenard et al, 2024 ). The aEEG with concurrent continuous video monitoring confirmed the presence of seizures ( Figure 1B ).…”

“…Clinically, seizures manifest in five primary forms: 1) motor, encompassing automatism, clonic, epileptic spasm, myoclonic, and tonic; 2) nonmotor, which includes autonomic and behavior arrest; 3) sequential; 4) electroencephalographic only; and 5) unclassified ( Pressler et al, 2021 ; Spenard et al, 2024 ). A systematic review indicates a notable association between specific clinical seizure types and their underlying etiologies.…”