Seizures in babies in the first month of life are not the same as seizures that occur in older children and adults. Babies normally have sudden, brief jerks, stares, grimaces, and mouth movements that resemble symptoms of epilepsy in older children or adults so it can even be difficult for even experts to tell if a baby is having a seizure.
Seizures in newborns often go away quickly but may recur as epilepsy in later childhood or in adulthood.
5 Signs & Symptoms of Seizures in a Baby
Symptoms of seizures in babies may include:
- Jerking or stiffening of a leg or an arm that can alternate from one side to the other
- The whole upper body may suddenly jerk forward
- Both legs may jerk up toward the abdomen with the knees bent
- Changes in facial expression, breathing, and heart rate
- Parent’s voices are unable to attract the newborn's attention
- Impaired responsiveness is often difficult to assess in newborns
Epilepsy is more likely to be diagnosed in infants when:
- Behavioral changes are not typical of children of the same age
- Repeated episodes are identical in their behavioral features and duration
- The episodes occur while the child is both awake and asleep
- The episodes are not brought on by changes in posture or activity, or cannot be stopped by gentle manipulation of the arm or leg
What Causes Seizures in Babies?
Causes of seizures in babies before one year of age include:
- Newborn illnesses (lack of oxygen, infection, hemorrhage, etc.)
- Abnormal brain development in the womb
- Genetic disorders
- Infection of the brain (encephalitis)
- Infection of the membranes covering the brain (meningitis)
- Febrile illness related seizures (febrile seizures)
How Are Seizures in Babies Diagnosed?
In addition to a medical history and physical examination tests and procedures used to diagnose the cause of seizures in babies may include:
- Magnetic resonance imaging (MRI) scan of the head with a special epilepsy protocol to diagnose structural abnormalities in the brain
- Electroencephalogram (EEG) to detect abnormal electrical activity in the brain
- Blood and urine tests to check for chemical disorders or metabolic problems
- Chromosomal studies to detect genetic disorders
- Spinal tap (lumbar puncture) to look for evidence of infection or metabolic disorders, or chemical disorders
What Is the Treatment for Seizures in Babies?
Treatment for seizures in babies depends on the cause and may include:
- Therapeutic hypothermia for neonatal encephalopathy
- Broad-spectrum antibiotics for infection
- Glucose solution for low blood sugar (hypoglycemia)
- Calcium gluconate or calcium chloride for low blood calcium (hypocalcemia)
- Magnesium sulfate for low blood magnesium (hypomagnesemia)
- Vitamin supplementation and other disease-modifying therapies for some cases of pyridoxine or PLP responsive seizures
- Antiepileptic drugs (AEDs) may be used to treat neonatal seizures and infantile spasms, such as:
- Phenobarbital (usually first-line therapy)
- Fosphenytoin
- Vigabatrin (Sabril) may be used to treat infantile spasms (West syndrome)
- Zonisamide (Zonegran) is under investigation for use in treating infantile spasms
- Lidocaine for babies who do not respond to phenobarbital
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https://www.epilepsy.com/learn/seizures-youth/about-newborns-and-infants/seizures-newborns
https://www.epilepsy.com/article/2014/3/medications-neonatal-seizures-and-infantile-spasms
https://www.uptodate.com/contents/treatment-of-neonatal-seizures#H2