Apneic seizures in the newborn
Electroclinical features of convulsive apnea and its relation to the behavioral state were described on the basis of polygraphic recordings from 21 newborns with various underlying disorders, including perinatal anoxia, purulent meningitis, and intracranial bleeding. The most frequent ictal discharges were rhythmic alpha waves, but other types of discharges, such as repeated sharp waves, rhythmic theta waves, delta waves, and repeated paroxysmal wave complexes, were also frequently seen. The area where the ictal discharges initially occurred or were most prominent was the temporal area, suggesting the limbic origin of apneic seizures. In more than half of the cases, the sleep cycle was abolished. In those cases where the sleep cycle was preserved, the seizures occurred most frequently in active sleep, but never in quiet sleep.
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- "Kellaway, 1987; Volpe, 2001). Eye opening has been used as one feature helping to distinguish between apnea of epileptic and nonepileptic origin (Watanabe et al., 1982) and between seizures and nonepileptic jitteriness (Volpe, 2001). Whether eyes are open during nonsubtle seizures has not so far been reported in the literature. "
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ABSTRACT: It has been shown that persistent eye closure during paroxysmal events in infants makes seizures unlikely. Our study aims to assess whether this is also true in neonates.
We reviewed and classified all archived neonatal seizures in our video database, considering electroclinical seizures only and excluding electrographic seizures and clinical seizures without ictal change in EEG. We assessed whether eyes were open during the seizure. One hundred and thirty-one electroclinical seizures (clonic, focal and generalized tonic, tonic-clonic, generalized myoclonic, subtle and spasms) in 46 neonates were included.
In 115 (88%) seizures, eyes were open; in 10 seizures, they were closed; and in six seizures, eye opening could not be evaluated. All 10 seizures with persistent eye closure were clonic seizures.
Our data demonstrate that persistent eye closure during an event suggestive of a seizure in a newborn makes an electroclinical seizure unlikely.
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