Symptomatic seizures
Symptomatic seizures in the newborn period may be temporary or may be the first sign of a serious epilepsy syndrome. Seizures following birth asphyxia or following a bleed or stroke in the brain often present within a few hours after delivery or after a bleed or stroke occur. These seizures may be difficult to control during the first hours to days, but are often well controlled within a few days after the initial seizure occurs. Prognosis is often based on the degree of brain injury seen on imaging (MRI/CT-scan), the baby's overall appearance and neurological exam, as well as how normal the EEG looks before, between and after seizures are controlled. For many babies after a brief period of treatment ranging from a few days to a few months, a decision to stop seizure medications may be made by your child's neurologist. However, a history of symptomatic seizures in the new born may be a risk factor to developing other types of epilepsy later in infancy or in early childhood.
Some newborns develop hard to control seizures in the first few days of life that last into infancy and early childhood. These infants are often found to have seizures caused by large malformations of the brain or a genetic or metabolic disorder. Seizures due to these causes usually carry a poor prognosis not only because the seizures are so hard to control but also because the underlying cause is associated with impairment of brain development or function. For these infants seizures may be very difficult or even impossible to control with medications and in some cases where one injured or malformed area of brain is found, epilepsy surgery may be recommended. For other babies found to have a metabolic disorder, certain dietary restrictions may be indicated. Seizures are often very different from those seen in newborns with other causes of seizures. Tonic (sudden sustained stiffening and posturing of the arms and body) or myoclonic (sudden quick random jerks of different limbs), can be seen and almost always these seizure types are associated with very serious forms of epilepsy. EEG monitoring often shows very abnormal brain waves between seizures which demonstrate how badly the brain is functioning.