Neonatal seizures or convulsions: All you must know, checks to detect them

Whenever any mum or dad hears that their baby is having convulsions or seizures – the primary response of the dad and mom is, “Isn’t the baby too young?”, “Can the baby get convulsions at this age?”, “Is the baby going to survive?”, “If they do – are they going to be normal?”, “Will they become epileptic?” All these are frequent questions which come throughout a mum or dad’s minds – some specific it and a few endure silently.

In an interview with HT Lifestyle, Dr Kishore Kumar, Neonatologist and Pediatrician at Cloudnine Group of Hospitals in Bengaluru, defined, “Neonatal convulsions are abnormal movements of the body or portions of the body due to abnormal activity in the brain. They are relatively rare, affecting 1 in 1000 live birth babies. The fact of life is that neonatal convulsions or seizures most often are preventable. Newborn babies’ brains develop too fast – their brain size (measured by head circumference is 35 cms at birth and by 2 years of age it is usually around 50 cms.) Adult head size is generally around 54 to 55 cms. It means that >90% of the brain growth happens in the first 2 years – so the brain of a newborn is susceptible to lot of insults – which can and should be prevented.”

He elaborated, “The convulsions in a newborn baby can either be “obvious” or “subtle” – which may simply be missed if the observant just isn’t skilled sufficient. The convulsions have to be handled. Development of the infant have to be monitored. Generally treating the underlying trigger is sufficient is most circumstances – like oxygen for hypoxia, calcium supplementation for hypocalcaemia, sugar for hypoglycaemia – however generally if the trigger is unknown or if the infant is getting repeated convulsions – we do use anti- convulsant meds – as required for few months. Obvious convulsions typically – relies on the variety of days of life and the causes are often anticipated from that.”

Obviously, these are common guidelines however Dr Kishore Kumar revealed that there are exceptions generally for each rule.

1. Most convulsions on first day of life are attributable to both lack of ample oxygen to the mind – known as asphyxia or attributable to beginning accidents inflicting vital swelling of the mind. Sometimes they might be attributable to malformations or deformations of the mind too.
2. Second day convulsions are often attributable to imbalances of some electrical chemical substances like low calcium, low magnesium, low sugar and different abnormalities which if corrected settles down.
3. Third day convulsions are often considered sinister – that means metabolic in nature – attributable to issues in digesting the meals both carbohydrates or proteins or fat – and the metabolites of those meals gadgets varieties poisonous molecules inflicting the convulsions often attributable to swelling of the mind, because of this. Identification of that is essential as harm happens by each hour – and that is the place Newborn Screening for metabolic problems is essential and in Cloudnine all infants are examined for these as a rule as per the worldwide good practices.
4. Fourth day convulsions typically might be both attributable to genetic predisposition or any of the above elements.
5. Fifth day convulsions – up to now historically have been known as “due to unknown factors” however recently we’ve got discovered deficiency of Biotin might be a causative issue.

Highlighting that refined convulsions are generally tough to pin level or diagnose and might be simply missed by new workers who’re inexperienced, Dr Kishore Kumar stated, “They could manifest in the form of unusual cry, or unusual movements or unusual behaviour or sometimes just cycling movements of arms or legs or both.”

Tests to detect neonatal convulsions

According to Dr Kishore Kumar, checks to detect neonatal convulsions embody blood checks for electrolyes, calcium, magnesium, metabolic screening and generally mind wave exercise take a look at EEG and scans like MRI Brain. He stated, “Prompt diagnosis of the cause of convulsions is important for effective treatment so that lifelong damage is prevented. These days, if no cause is found, then we can screen for any genetic cause by doing genomic studies for convulsions.”

He concluded, “Overall, generally the prognosis for convulsions in newborn are fairly good provided their cause is identified and rectified as soon as possible. The longer it takes to identify the cause the greater the damage to the brain. Parents, staff, and relatives are all anxious when a baby is convulsing. Convulsions are usually stopped by giving anti- convulsant medication/s. Ultrasound head or MRI brain and EEG are sometimes required to identify the cause of the convulsions.”