NON-EPILEPTIC CAUSES OF SEIZURES IN NEONATES: DIFFERENTIAL DIAGNOSIS AND CLINICAL MANAGEMENT
DOI:
https://doi.org/10.56238/levv16n53-118Keywords:
Newborn, Neonatal Seizures, Non-epileptic Causes, Differential Diagnosis, Clinical ManagementAbstract
Introduction: Neonatal seizures are among the most frequent neurological manifestations in newborns and represent a major diagnostic challenge. However, a significant proportion of these episodes are not epileptic in origin but result from metabolic, genetic, structural, or functional disturbances. Differentiating epileptic from non-epileptic seizures is essential for appropriate management and to avoid unnecessary pharmacological interventions. Methods: A systematic literature review was conducted using the PubMed, SciELO, and LILACS databases, covering studies published between 1999 and 2024. Portuguese and English descriptors were combined with Boolean operators, including “neonatal seizures,” “non-epileptic causes,” “differential diagnosis,” and “clinical management.” After screening titles, abstracts, and full texts, sixteen studies met the eligibility criteria, addressing etiological, diagnostic, and therapeutic aspects of non-epileptic seizures in neonates. Results: The most frequently reported causes were hypoglycemia, hypocalcemia, hypoxic-ischemic encephalopathy, genetic channelopathies, and benign paroxysmal events such as hyperekplexia and benign neonatal sleep myoclonus. Most episodes were transient and showed no epileptiform activity on EEG. A detailed clinical evaluation combined with continuous electroencephalographic monitoring, metabolic assessment, neuroimaging, and genetic testing proved essential for accurate differential diagnosis. Therapeutic management focused on the correction of underlying causes, with anticonvulsant use restricted to confirmed epileptic cases. Conclusion: Recognizing non-epileptic causes of neonatal seizures is crucial for safe and effective clinical practice. Early etiological identification reduces unnecessary medication use, improves neurological outcomes, and promotes individualized and evidence-based neonatal care.
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