How are neonatal seizures treated?

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A. Seizure activity in a newborn is both alarming and dangerous.  It is alarming because it usually is one of the first signs that a baby has brain damage such as hypoxic-ischemic encephalopathy (this is the most common cause of neonatal seizures).  Seizures are dangerous because they can cause further damage to a baby’s delicate brain.  First, it is important to determine the underlying cause of a baby’s seizures. If the cause can be treated, treatment must be started immediately.  If physicians suspect that a baby has an injury stemming from oxygen deprivation during or near the time of delivery, hypothermia therapy (brain cooling treatment) should be given to help minimize or prevent permanent brain damage.  The key with hypothermia therapy is that treatment must be initiated within six hours of the injury for best results. In addition to finding and treating the underlying cause of seizure activity, many physicians give anti-epileptic medications to try to stop seizures from occurring.  This is important because the longer the seizures last and the more frequently they occur, the more likely it is that permanent brain damage will result.

Seizure Treatment Options Require Great Care to Prevent Adverse Effects

It is crucial for physicians to stop seizure activity in a baby. For this reason, giving a baby antiepileptic medications is not uncommon.  However, seizure treatment is a controversial issue.  Drug options are limited and disappointing, but research shows that when a baby is not given antiepileptic medication, outcomes are much worse.  The overall risk of permanent brain damage following a neonatal seizure is as high as 30%.

Antiepileptic medications can be toxic to a baby’s brain, so physicians must be very careful when giving these medications to babies.  Research on neonatal seizure medications has shown the following:

  • Phenobarbital still remains the first-line choice for seizure treatments because physicians have much more experience with the medication.
  • Medications that do not contain compounds toxic to the baby’s brain should be used.  Hospitals should have specific guidelines for use of seizure medications.
  • In most cases, term babies should receive different medications than preterm babies.
  • Babies receiving hypothermia therapy must be assessed differently than babies not receiving brain cooling treatments.  Topiramate may be beneficial when administered along with hypothermia therapy.
  • Bumetanide seems to be the most promising drug for term newborns due to its very specific mode of action.  Recent research indicates that bumetanide used in combination with phenobarbital may actually reverse seizure damage in the brain.
  • Levetiracetam and topiramate seem promising in babies who cannot tolerate phenobarbital.
  • Seizures must be controlled quickly, and when possible, treatments that protect the brain should be implemented.
  • Diagnosing diseases that can cause seizures is crucial, such as certain metabolic disorders (disorders that prevent a baby from properly utilizing energy from food).
  • Dosages for seizure medications should be based on gestational age.

Seizure Treatment Requires Close Monitoring

Babies at risk of having seizures and those that have already had a seizure must be closely monitored. Sometimes the only sign of seizure is activity on an EEG (electroencephalography – brain activity monitoring).

Cardiopulmonary monitoring devices may also alert the medical team that the baby may be having a seizure. One sign of a seizure is apnea (periodic cessation of breathing), and monitoring devices can detect this. In addition, breathing rate and heart rate may change during a seizure, which can also be detected on a monitor.

Many times, a seizure can be observed. If anyone on the medical team witnesses signs of a seizure, such as the body going limp, the baby losing consciousness, or the baby staring and/or making bicycle “pedaling” movements, EEG monitoring and diagnosis of seizure activity must promptly take place.

If a seizure is diagnosed, the underlying cause must be found and timely treated. Very close monitoring must also occur if antiepileptic therapy is initiated.  Seizure treatment can be dangerous in many ways, including being toxic to the brain.  In addition to standard monitoring, medical staff must monitor drug levels in the blood, as well as liver and kidney function.

Managing seizure disorders in kids

Award-Winning Birth Injury Lawyers Serving Michigan & Throughout the Country

Failure to timely diagnose and treat seizure activity is negligence, and this includes failure to treat the seizure’s underlying cause.  Failure to properly monitor a baby that is given medication, and failure to properly administer seizure medications can be dangerous and negligent.  If this negligence leads to injury in the baby, it is medical malpractice. If your baby suffered from seizures and has permanent disabilities, such as cerebral palsy or intellectual disabilities, please contact the birth injury attorneys at Reiter & Walsh ABC Law Centers.

We have helped children throughout the country obtain compensation for lifelong treatment, therapy, and a secure future, and we give personal attention to each child and family we represent. Our firm has numerous multi-million dollar verdicts and settlements that attest to our success, and you pay nothing unless we win your case. Email or call Reiter & Walsh ABC Law Centers at 888-419-2229 for a free case evaluation. Our firm’s award-winning lawyers are available 24 / 7 to speak with you.

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