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The Jittery Baby and Seizures

  • Lu-Ann Papile
Chapter

Abstract

Seizure-like activity is common in the neonatal period. However, epilepsy (a group of neurological disorders characterized by epileptic seizures) makes up only a small fraction of these events. It is important for providers of newborn care to be aware of and recognize nonepileptic activity that resembles seizures in order to avoid unnecessary diagnostic tests and treatment. This chapter reviews the presentation and treatment, when indicated, of neonatal seizure-like events including secondary apnea, jitteriness, neonatal encephalopathy, benign neonatal sleep myoclonus, and neonatal abstinence syndrome.

Keywords

Seizures Apnea Jitteriness Encephalopathy Myoclonus 

References

  1. 1.
    Visser AM, Jaddoe VW, Arends LR, Tiemeir H, Hofman A, Moll HA, Steegers EAP, Breteler MMB, Arts WFM. Paroxysmal disorders in infancy and their risk factors in a population-based cohort: the generation R study. Dev Med Child Neurol. 2010;52:1014–20.CrossRefGoogle Scholar
  2. 2.
    Gunn AJ, Gluckman PD, Gunn TR. Selective head cooling in newborn infants after perinatal asphyxia: a safety study. Pediatrics. 1998;102(4 pt 1):885–92.CrossRefGoogle Scholar
  3. 3.
    Azzopardi D, Robertson NJ, Cowan FM, Rutherford MA, Rampling M, Edwards AD. Pilot study of treatment with whole body hypothermia for neonatal encephalopathy. Pediatrics. 2000;106(4):684–94.CrossRefGoogle Scholar
  4. 4.
    Weiner GM, editor. Textbook of neonatal resuscitation. 7th ed. Elk Grove Village: American Academy of Pediatrics; 2016.Google Scholar
  5. 5.
    Apgar V. A proposal for a new method of evaluation of the newborn infant. Curr Res Anesth Analg. 1953;32(4):260–7.PubMedGoogle Scholar
  6. 6.
    Apgar V. The newborn (Apgar) scoring system: reflections and advice. Pediatr Clin North Am. 1966;13:645–50.CrossRefGoogle Scholar
  7. 7.
    Pomerance J. Interpreting umbilical cord blood gases. 2nd ed. Pasadena: BNMG; 2004.Google Scholar
  8. 8.
    Sarnat HB, Sarnat MS. Neonatal encephalopathy following fetal distress: a clinical and electroencephalographic study. Arch Neurol. 1976;33(10):696–705.CrossRefGoogle Scholar
  9. 9.
    Volpe JJ. Neurology of the newborn. 5th ed. Philadelphia: Saunders Elsevier; 2008.Google Scholar
  10. 10.
    Parker S, Zuckerman B, Bauchner H, et al. Jitteriness in full-term infants: prevalence and correlates. Pediatrics. 1990;85(1):17–23.PubMedGoogle Scholar
  11. 11.
    Parks D, Yetman RJ. The jittery newborn. J Pediatr Health Care. 2001;15(3):147–9.CrossRefGoogle Scholar
  12. 12.
    Adamkin D. Postnatal glucose homeostasis in late-preterm and term infants. Pediatrics. 2011;127(3):575.CrossRefGoogle Scholar
  13. 13.
    Kilpatrick SJ, Papile LA, editors. Guidelines for perinatal care. 8th ed. Washington, DC/Elk Grove Village: American College of Obstetricians and Gynecologists/American Academy of Pediatrics; 2017.Google Scholar
  14. 14.
    Hudak ML, Tan RC. Neonatal drug withdrawal. Pediatrics. 2012;129(2):e540–938.CrossRefGoogle Scholar
  15. 15.
    Shankaran S, Laptook AR, Ehrenkranz RA, et al. National Institute of Child Health and Human Development neonatal Research Network. Whole body hypothermia for neonates with hypoxic-ischemic encephalopathy. N Engl J Med 2005;353(15):1574–84.Google Scholar
  16. 16.
    Gluckman PD, Wyatt JS, Azzopardi D, et al. Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicenter randomized trial. Lancet. 2005;365(9460):663–70.CrossRefGoogle Scholar
  17. 17.
    Azzopardi DV, Strohm B, Edwards AD, et al. TOBY Study Group. Moderate hypothermia to treat perinatal asphyxial encephalopathy. N Engl J Med. 2005;361(14):1349–58.CrossRefGoogle Scholar
  18. 18.
    Jacobs SE, Morley CJ, Inder TE, et al. Infant Cooling Evaluation Collaboration. Whole-body hypothermia for term and near-term newborns with hypoxic-ischemic encephalopathy; a randomized clinical trial. Arch Pediatr Adolesc Med. 2011;165(8):692–700.CrossRefGoogle Scholar
  19. 19.
    Wyatt JS, Gluckman PD, Lui PY, et al. Cool-Cap Study Group. Determination of outcomes after head cooling for neonatal encephalopathy. Pediatrics. 2007;119(5):912–21.CrossRefGoogle Scholar
  20. 20.
    Laptook A, Tyson J, Shankaran S, et al. National Institute of Child Health and Human Development Neonatal Research Network. Elevated temperature after hypoxic-ischemic encephalopathy: risk factor for adverse outcomes. Pediatrics. 2008;112(3):491–9.CrossRefGoogle Scholar
  21. 21.
    DeSai RJ, Huybrechts KF, Hernandez-Diaze S, Moqun H, Patomo E, Kaltenbach K, Kertzner LS, Bateman B. Exposure to prescription opioid analgesics in utero and risk of neonatal abstinence syndrome: a population based cohort study. BMJ. 2015;350:h2102.CrossRefGoogle Scholar
  22. 22.
    Huybrechts KF, Bateman BT, Desai RJ, Hernandez-Diaz S, Rough K, Mogun H, Kerzner LS, Davis JM, et al. Risk of neonatal drug withdrawal after intrauterine co-exposure to opioids and psychotropic medications: cohort study. BMJ. 2017;358:j3326.CrossRefGoogle Scholar
  23. 23.
    Bagley SM, Wachman EM, Holland E, Brogly SB. Review of the assessment and management of neonatal abstinence syndrome. Addict Sci Clin Pract. 2014;9(1):19.CrossRefGoogle Scholar
  24. 24.
    Kaltenback K, Finnegan LP. Neonatal abstinence syndrome, pharmacotherapy and developmental outcome. Neurobehav Toxicol Teratol. 1986;8(4):353–5.Google Scholar
  25. 25.
    Doberczak TM, Shanzer S, Senie RT, Kandall SR. One-year follow-up of infants with abstinence-associated seizures. Arch Neurol. 1988;45(6):649–53.CrossRefGoogle Scholar
  26. 26.
    Kraft WK, Adeniyi-Jones SC, Chervoneva I, Abatemarco D, Kaltenbach K, Ehlirch ME. Buprenorphine for the treatment of neonatal abstinence syndrome. N Engl J Med. 2017;376(24):2341–8.CrossRefGoogle Scholar
  27. 27.
    Sachs HC. The transfer of drugs and therapeutics into human milk: a update on selected topics. Pediatrics. 2013;132:e796–809.CrossRefGoogle Scholar
  28. 28.
    Hall ES, Wexelblatt SL, Crowley M, Grow JL, Jasin LR, Klebanoff MA, McClead RE, Meinzen-Derr J, Mohan VK, Stein H, Walsh MC, OCHNAS Consortium. Implementation of a neonatal abstinence syndrome protocol weaning protocol: a multicenter cohort study. Pediatrics. 2016;136(4):e803–10.CrossRefGoogle Scholar
  29. 29.
    Mauer VO, Rizzi M, Bianchetti MG, Ramelli GP. Benign neonatal sleep myoclonus: a review of the literature. Pediatrics. 2010;125(4):e19–24.Google Scholar
  30. 30.
    Huntsman RJ, Lowry NJ, Sankaran K. Nonepileptic motor phenomenon in the neonate. Peadiatr Child Health. 2008;13:680–4.CrossRefGoogle Scholar
  31. 31.
    Cohen R, Shuper A, Straussberg R. Familial benign neonatal sleep myoclonus. Pediatr Neurol. 2007;36(5):334–7.CrossRefGoogle Scholar
  32. 32.
    Cross JH. Differential diagnosis of epileptic seizures in infancy including the neonatal period. Semin Fetal Neonatal Med. 2013;18:192–5.CrossRefGoogle Scholar
  33. 33.
    Di Capua M, Fusco L, Ricci S, Vigevano F. Benign neonatal sleep myoclonus: clinical features and video-polygraphic recordings. Mov Disord. 1993;8(2):191–4.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of Neonatology, Department of PediatricsUniversity of New Mexico Health Sciences Center, University of New MexicoAlbuquerqueUSA

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