OVERVIEW

Seizures in Neonates: Diagnosis and Management in the Emergency Department (Pharmacology CME) is organized by EB Medicine.

Date of Original Release: June 1, 2020
Termination Date: June 1, 2023

Description:
Seizures in neonates can be difficult to diagnose because they often present with subtle signs and symptoms. Patient stabilization, seizure cessation, and determination of the etiology are key aspects of emergency department management. This issue reviews common presentations and causes of neonatal seizures, provides recommendations for management in the emergency department, and evaluates existing evidence regarding antiepileptic medications for the treatment of neonatal seizures. You will learn:
• Common presentations of neonatal seizures, and how to distinguish those from benign mimics of seizures
• Various etiologies for neonatal seizures, and which are the most common
• How the timing of the presentation can help determine the cause of the seizure
• Key components of the physical examination that should be conducted for neonates with seizure activity
• What types of diagnostic studies are indicated, and which are the highest yield
• Which antiepileptic drugs have the most evidence supporting their use in neonates, as well as which are recommended as first-line, second-line, and third-line choices
• Recommendations for non–antiepileptic drug management of neonatal seizures
• Which neonates should be admitted, when admission to a pediatric or neonatal intensive care unit is warranted, and under which circumstances a neonate can be discharged

CME Objectives:
Upon completion of this article, you should be able to:
• Recognize neonatal seizures, risk factors, and contributing factors
• Build a thorough differential diagnosis, including benign mimics
• Determine an appropriate diagnostic approach, including laboratory studies, testing, and imaging
• Describe an appropriate management approach to neonatal seizures