Monday, January 12, 2015

Neonatal Seizures 

Incidence range from 1-2% to almost 20% in preterm infants. Neonatal seizure present in decreasing order of frequency
Types

  1. Subtle seizure
  2. Focal clonic seizure
  3. Generalized tonic seizures
  4. Myoclonic seizures
Causes
  1. Meningitis -Ceftriaxone maximum 10dyas
  2. Encephalitis
  3. HIE (Hypoxic Ischemic Encephalopathy) most common
  4. Acute metabolic disturbance
    1. Hypoglycemia
    2. Hypocalcemia
    3. Hypomagnesaemia
    4. Hyper,Hyponatriumiaa
    5. Hemorrhage
Investigation
  1. Tc
  2. Dc
  3. ESR
  4. Hb%
  5. Platelates
  6. RFT
  7. LFt
  8. CT scan
  9. MRI
  10. CSF
Treatment
  1. Causative
    1. Hypoglycemia-10% Dextrose 2ml/kg bolus stat and maintance
    2. Hypocalcemia-Calcium glucanate 2ml/kg
    3. Anti convulsion
      1. Dizepamp -0.1-0.2mg/kg state slowly
      2. Phenobarbiton-20mg/kg/dose then maintenance 3-5mg/kg/day in 24 hrs
      3. Sodium valproate -

—Usual Dosage Range
  1. • Mania: 1200 mg/day
    • Migraine: 500 mg/day
    • Epilepsy: 10–40 mg/kg/day

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