Neurological Disorders of the Neonate Flashcards
What are seizures?
excessive, repetitive electrical discharges in the CNS
Is seizure a symptom or a disease?
Symptom –> represents an underlying disease process that causes disturbances in the brain
What are the common causes of neonatal seizures?
hypoxic-ischaemic encephalopathy
cerebral infarction
cerebral trauma
sepsis
metabolic abnormalities
narcotic drug withdrawal
What is the differential diagnosis for jitteriness?
no autonomic charges
symmetrical rapid movements of the hands and feet
stimulus sensitive, initiated often to sudden movement and noise
no associated eye movements
What is the differential diagnosis of benign neonatal sleep myoclonus?
bilateral/unilateral jerking during sleep
occurs during active sleep
not stimulus sensitive often involve upper > lower trunk
What are the subtle seizure cues?
eye signals: staring, deviation, blinking
buccal-oral-lingual: chewing, lip smacking, sucking
limbs: cycling, rowing
systemic: apnoea, BP alterations
What are the clonic seizure cues?
rhythmic jerks
slow decline in rate as seizure persists
focal/multifocal
What are the myoclonic seizure cues?
rapid, isolated jerking of muscles
upper limb movement more common
What are the tonic seizure cues?
sustained posturing of the limbs or trunk/neck
generalized tonic seizures often manifest with tonic extension of the upper and lower limbs in an opisthotonic fashion
What does CFM stand for?
Cerebral function monitoring
What are the steps of seizure management?
medications
check blood glucose
check electrolytes
maintain airway
maintain breathing
maintain circulation
What is HIE?
Hypoxic Ischemic Encephalopathy
form of brain injury caused by the restricted flow of oxygen to the brain
What is the primary energy failure (mechanism of hypoxic brain injury)?
hypoxia –> diving reflex –> anaerobic metabolism –> rapid depletion of ATP/severe cell oedema –> accumulation of lactic acid –> failure of normal metabolic activity –> intracellular dysfunction/multi-organ failure –> nuronal ell apoptoaia/neonatal death
What is the pathophysiology of HIE in primary energy failure?
primary energy failure
latent phase commences
complete recovery OR
development of secondary energy failure
What is the pathophysiology of HIE in secondary energy failure?
occurs 6-15hrs after initial hypoxic insult
