Paeds Cases · fetal-neonatal-and-perinatal
Neonatal seizures and encephalopathy — structured clinical encounter
Structured encounter testing the approach to an encephalopathic term infant with neonatal seizures: recognition, cooling eligibility, the antiseizure-medication ladder and the role of continuous EEG.
On this page
Study tools
Target exams
Station brief (candidate)
You are the neonatal registrar. A term infant born after an emergency caesarean for placental abruption is admitted to the neonatal unit at 2 hours of age with lethargy, hypotonia, depressed primitive reflexes, and rhythmic focal clonic movements of the left arm. Cord blood pH was 6.85, base deficit 16 mmol/L. The team asks you to establish the diagnosis, the neuroprotective plan, and the stepwise antiseizure management. You have 12 minutes with the team and 5 minutes for examiner discussion. [1]
References6ShowHide
- [1]Azzopardi DV; Strohm B; Edwards AD; et al Moderate hypothermia to treat perinatal asphyxial encephalopathy. N Engl J Med, 2009.PMID 19797281
- [4]Painter MJ; Scher MS; Stein AD; et al Phenobarbital compared with phenytoin for the treatment of neonatal seizures. N Engl J Med, 1999.PMID 10441604
- [5]Pressler RM; Abend NS; Auvin S; et al Treatment of seizures in the neonate: Guidelines and consensus-based recommendations-Special report from the ILAE Task Force on Neonatal Seizures. Epilepsia, 2023.PMID 37655702
- [7]Sharpe C; Reiner GE; Davis SL; et al Levetiracetam Versus Phenobarbital for Neonatal Seizures: A Randomized Controlled Trial. Pediatrics, 2020.PMID 32385134
- [8]Shellhaas RA; Chang T; Tsuchida T; et al The American Clinical Neurophysiology Society's Guideline on Continuous Electroencephalography Monitoring in Neonates. J Clin Neurophysiol, 2011.PMID 22146359
- [10]Basti C; Maranella E; Cimini N; et al Seizure burden and neurodevelopmental outcome in newborns with hypoxic-ischemic encephalopathy treated with therapeutic hypothermia: A single center observational study. Seizure, 2020.PMID 33160202