The Classification, Management, and Future Directions of Neonatal Seizures: Elissa Yozawitz, MD

WATCH TIME: 5 minutes

“For seizure semiology, there are specific things that babies do at the bedside that give clues for prognosis workup and management. With neonatal seizures, the sooner you recognize them, the sooner you could diagnose them, the sooner you could treat them. I think recognizing [these clues] early can make us go down the right path for treatment to hopefully stop the seizures.”

Neonatal seizures occur in 2.29 cases per 1000 live births, typically occurring within 4 weeks after birth in full-term infants or within 44 weeks of postmenstrual age in preterm infants.¹ In a recently published review article in the New England Journal of Medicine, the prognosis and treatment of neonatal seizures were discussed, as well as newly defined neonatal epilepsy syndromes. The review also emphasized the importance of EEG monitoring and genetic testing for this specific patient population.

The review, written by Elissa Yozawitz, MD, pediatric epileptologist and director of neonatal neurology at the Children’s Hospital at Montefiore, included updated recommendations and a diagnostic framework for neonatal seizures, which was done in collaboration with The International League against Epilepsy (ILAE). The review also shared guidance on how to work up and treat neonatal seizures, aiming to help clinicians to streamline management for these patients.

Yozawitz, an associate professor of neurology at Albert Einstein College of Medicine, sat down with NeurologyLive® in an interview to discuss this important work. She talked about some of the key factors that indicate prognosis and guide management in neonatal seizure semiology. Yozawitz also spoke about how the classification of neonatal seizures differs from seizures in older populations, as well as the current challenges in conducting research and clinical trials on neonatal seizures.

REFERENCES
1. Yozawitz E. Neonatal Seizures. N Engl J Med. 2023;388(18):1692-1700. doi:10.1056/NEJMra2300188