Neonatal Seizures (Infant Seizures) and Birth Injury

Seizures are involuntary jerking movements, caused by abnormal electrical patterns in the brain from brain damage or problematic neurochemistry. Neonatal seizures – seizures in a baby – are often subtle and difficult to identify. They can be caused by a number of factors, including hypoxic-ischemic encephalopathy (HIE), infections, trauma, and prolonged labor and delivery. HIE and fetal oxygen deprivation are the most common causes. Neonatal seizures can also worsen existing brain damage.

What Are Seizures? Seizures in Kids and Babies

What Are Neonatal Seizures?

Seizures occur from abnormal electrical discharges in the brain, which are due to nerve damage or problems with the brain’s chemistry. Seizures can cause involuntary jerking movements lasting from a few seconds to a few minutes, and can affect normal brain functioning. They sometimes affect consciousness. Seizures must be immediately diagnosed and properly treated in newborns in order to prevent permanent damage to the baby.

Seizures in newborns are categorized as subtle, clonic, tonic, or myoclonic:

  • Subtle seizures, as the name implies, are often difficult to see. They comprise about 50% of all newborn seizures, and are especially frequent in premature infants. There may be some bicycling-type movement, fixation of gaze, or repetitive facial movements.
  • Clonic seizures in infants are marked by a slow rhythmic jerk of one part of the body. This type of seizure represents about 25% of all seizures in newborns.
  • Myoclonic seizures involve rapid twitching or jerking movements, and are often the most serious type of neonatal seizure. Myoclonic seizures may indicate severe brain damage. Premature babies are the most afflicted group.
  • Tonic seizures account for about 5% of infant seizures and cause sustained contractions. Sometimes the eyes may roll upward and breathing may stop for a period of time.

Causes of Neonatal Seizures

Seizures can be caused by a number of things, including:

Seizures From HIE (Hypoxic-Ischemic Encephalopathy)

Hypoxic ischemic encephalopathy (HIE or birth asphyxia) is the most common cause of neonatal seizures, with an estimated 80% of cases attributed to HIE. HIE is a medical condition in which a newborn has been deprived of oxygen at or around the time of birth. Some of the medical emergencies that could result in HIE and seizures include cord compression, problems with the placenta or uterus such as a ruptured uterus or placenta previa, fetal distress, and prolonged labor. Medical staff must plan appropriately for these kinds of obstetrical risks. Furthermore, they must effectively handle situations that may arise during delivery in order to minimize the possibility of HIE. Failure of doctors or other health care professionals to do these things could be considered negligence.

Seizures From Infection

The most common infections occurring in newborns that can cause seizures are meningitis, Group B Streptococcus, encephalitis, cytomegalovirus and herpes simplex virus. While infants may become infected after delivery, the most common cause of neonatal infection is undetected and untreated infection in the mother that is transmitted to the baby through the birth canal. It is the doctor’s or other healthcare provider’s responsibility to screen for various infections during the pregnancy and appropriately treat them.

Seizures From Traumatic Brain Injury

Traumatic birth injuries can result from a problem with the size or position of a fetus relative to the birth canal. For example, sometimes a baby’s head is too large for the mother’s pelvis (cephalopelvic disproportion) or the baby may just be very large (macrosomic). Again, it is the responsibility of the doctor or other healthcare provider to prenatally check and plan for these types of obstetrical problems. Traumatic brain injuries can also occur from the use of instruments like forceps or vacuum extractors during vaginal deliveries. Forceps resemble tongs. Proper placement requires that the “blades” lie evenly against a baby’s head in a location where they are not likely to cause damage. If the forceps are applied unevenly to the baby’s head, skull and facial fractures as well as intracranial hemorrhages, seizures, and permanent brain damage can occur.  Vacuum extractors, as the name implies, use suction to pull a baby from the birth canal during a contraction. A small plastic cup is attached to the infant’s head. If it is not correctly placed, bruising, hemorrhages and blood clots can occur. Doctors and other healthcare providers must use forceps and vacuum extractors correctly and at the right stage of labor in order to avoid irreparable damage.

Seizures From Prolonged Second Stage of Labor

The second stage of labor occurs from the time the mother is fully dilated until the baby is delivered. When this time lasts more than four hours, it is considered to be a prolonged second stage. A prolonged second stage is most often associated with cephalopelvic disproportion. A C-section should be done to minimize the risks of brain injury. Failure to perform a timely C-section may be considered negligence.

Diagnosing Neonatal Seizures

The primary diagnostic test for verifying seizure activity and determining the part of the brain affected is an EEG. In an EEG, electrodes are temporarily attached to the baby’s head. The electrodes read the electrical activity of the brain and show the changes that occur over time. The results appear on-screen as well as on printed strips.

What Do You Do if a Baby Has a Seizure?

If a baby has a seizure, it’s imperative to get them medical care. When parents first identify a seizure, they should:

  • Place the baby on a soft surface and make sure they are safe.
  • Loosen the baby’s clothing.
  • Keep everything away from the baby’s mouth.
  • Prevent choking by putting them on their side or stomach.
  • Make sure the baby is breathing.
  • Keep the baby’s airway clear by wiping away saliva and debris from the mouth.
  • Time how long the seizure lasts.
  • If your baby has a history of seizures, administer anti-seizure medication prescribed by the doctor.
  • If possible, get a videorecording of the seizure to show the doctor
  • Seek medical attention immediately (call 911) if:
    • This is the child’s first seizure
    • Seizures last more than 3 minutes
    • The baby has trouble breathing
    • The baby is choking or turning blue
    • The baby has a fever of 104 degrees or more
    • Multiple seizures in a single day
  • Seek help from your child’s pediatrician or emergency room as soon as possible to help identify the underlying cause of the seizures

Disclaimer: This page is intended solely as an educational tool for parents. It is not intended as – and should not be mistaken for – medical advice. If you have any medical concerns about your baby – such as seizures – please seek medical attention immediately. Neonatal seizures are a condition that must be evaluated by a medical professional.

Legal Help for Neonatal Seizures

Michigan Birth Injury Lawyers with a National Presence

Newborn seizures can be an indication of serious neurological damage from a number of birth-related injuries. If your baby or child suffers from seizures that began around the time of birth, contact Reiter & Walsh ABC Law Centers.  The award-winning birth injury lawyers at Reiter & Walsh have helped dozens of children affected by seizures. Jesse Reiter, the firm’s president, has been focusing on birth injury cases his entire legal career, and most of Jesse’s cases involve helping children who have seizure disorders, cerebral palsy, and hypoxic ischemic encephalopathy (HIE). The birth injury lawyers at ABC Law Centers have won numerous awards for their child advocacy and are members of the Birth Trauma Litigation Group (BTLG) and the Michigan Association for Justice (MAJ).

To find out if you have a case, contact our firm to speak with an experienced lawyer. We handle cases all over the United States, in places including Pennsylvania, Tennessee, Mississippi, Texas, Wisconsin, Michigan, Ohio, Washington D.C., Arkansas, and more. Additionally, our team handles cases involving military hospitals and federally-funded clinics.

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Video: Seizures in Babies

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  • Thibeault-Eybalin MP, Lortie A, Carmant L. Neonatal seizures: do they damage the brain? Pediatr Neurol 2009; 40:175.
  • Chapman KE, Mizrahi EM, Clancy, RR. Neonatal seizures. In: Wyllie’s Treatment of Epilepsy: Principles and Practice, 5th, Lippincott, Williams & Wilkens, Philadelphia.

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