Abstract
Purpose of Review
Although differentiating neonatal-onset epilepsies from acute symptomatic neonatal seizures has been increasingly recognized as crucial, existing guidelines, and recommendations on EEG monitoring are mainly based on acute symptomatic seizures, especially secondary to hypoxic-ischemic encephalopathy. We aimed to narratively review current knowledge on neonatal-onset epilepsies of genetic, metabolic, and structural non-acquired origin, with special emphasis on EEG features and monitoring.
Recent Findings
A wide range of rare conditions are increasingly described, reducing undiagnosed cases. Although distinguishing features are identifiable in some, how to best monitor and detect less described etiologies is still an issue. A comprehensive approach considering onset, seizure evolution, ictal semiology, clinical, laboratory, EEG, and neuroimaging data is key to diagnosis.
Summary
Phenotypic variability prevents precise recommendations, but a solid, consistent method moving from existing published guidelines helps in correctly assessing these newborns in order to provide better care, especially in view of expanding precision therapies.
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Abbreviations
- aEEG:
-
Amplitude-integrated EEG
- ARX:
-
X-linked aristaless-related homeobox gene
- BFNIE:
-
Benign familial neonatal-infantile epilepsy
- BRAT1:
-
BRCA1 associated ATM activator 1
- c-EEG:
-
Conventional-EEG
- CDKL5:
-
Cyclin dependent kinase like 5
- COL4A1:
-
Collagen type IV alpha1 chain
- EEG:
-
Electroencephalogram
- EIMFS:
-
Epilepsy of infancy with migrating focal seizures
- EME:
-
Early myoclonic encephalopathy
- FGF12:
-
Fibroblast growth factor 12
- GCS:
-
Glycine cleavage system
- GNAO1:
-
G protein subunit alpha o1
- HIE:
-
Hypoxic-ischemic encephalopathy
- ILAE:
-
International League Against Epilepsy
- IVH:
-
Intraventricular hemorrhage
- MOCS1:
-
Molybdenum cofactor synthesis 1
- NSE:
-
Neonatal status epilepticus
- PACS2:
-
Phosphofurin acidic cluster sorting protein 2
- PDE:
-
Pyridoxine-dependent epilepsy
- PIGT:
-
Phosphatidylinositol-glycan biosynthesis class T
- PLP:
-
Pyridoxal 5′-phosphate
- PNPO:
-
Pyridox(am)ine 5′-phosphate oxidase
- PRRT2:
-
Proline-rich transmembrane protein 2
- SIK1:
-
Salt-induced kinase 1
- SPTAN1:
-
Spectrin alpha, non-erythrocytic 1
- STXBP1:
-
Syntaxin binding protein 1
- SUOX:
-
Sulfite oxidase
- TBC1D24:
-
TBC1 domain family member 24
- TSC:
-
Tuberous sclerosis complex
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Pisani, F., Spagnoli, C. & Fusco, C. EEG Monitoring of the Epileptic Newborn. Curr Neurol Neurosci Rep 20, 6 (2020). https://doi.org/10.1007/s11910-020-1027-7
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DOI: https://doi.org/10.1007/s11910-020-1027-7