Pharmacology > Seizures > Flashcards

Seizures Flashcards

(39 cards)

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1
Q

What is the highest seizure risk period in neonates?

A

First month of life

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2
Q

What is the incidence of seizures in live births?

A

1–3.5 per 1000 live births

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3
Q

What percentage of term infants experience seizures?

A

0.5%

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4
Q

What percentage of preterm infants experience seizures?

A

Up to 22.2%

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5
Q

What is the most common cause of neonatal seizures?

A

Acute brain injury

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6
Q

What are the potential impairments caused by neonatal seizures?

A
  • Cerebral palsy (CP)
  • Intellectual disability
  • Epilepsy
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7
Q

What is the mortality rate for preterm infants with seizures?

A

35%

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8
Q

What is the mortality rate for term infants with seizures?

A

15%

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9
Q

Why is prompt recognition and treatment of seizures critical?

A

To prevent brain damage and other complications

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10
Q

What are the adverse effects of antiseizure medications?

A
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11
Q

What is the most common cause of neonatal seizures?

A

Hypoxic Ischemic Encephalopathy (HIE) – 40%

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12
Q

What are the less common causes of neonatal seizures?

A
  • CNS infections
  • Brain malformations
  • Metabolic abnormalities
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13
Q

What are treatable metabolic causes of seizures?

A
  • Hypoglycemia
  • Hyponatremia
  • Hypocalcemia
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14
Q

Define ‘seizure’ in the context of neonatal seizures.

A

Abnormal electrical brain activity; may have no motor signs.

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15
Q

Define ‘convulsion’ in the context of neonatal seizures.

A

Refers to motor symptoms (e.g., jerking).

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16
Q

What is the EEG definition of a seizure?

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A

≥ 2 µV, ≥ 10 seconds, evolves with clear beginning, middle, end

17
Q

What role does glutamate play in seizures?

Study These Flashcards
A

It is an excitatory neurotransmitter.

18
Q

What role does GABA play in seizures?

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A

It is an inhibitory neurotransmitter.

19
Q

What is the neonatal susceptibility to seizures characterized by?

Study These Flashcards
A
  • Excess excitation
  • Less inhibition
  • Poorly developed ATP membrane pumps
20
Q

What are maternal/prenatal risk factors for neonatal seizures?

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A
  • TORCH infections
  • Preeclampsia
  • Fetal distress
21
Q

What delivery/postnatal factors can increase seizure risk?

Study These Flashcards
A
  • Low Apgars
  • Sepsis
  • Drug withdrawal
  • Temperature or BP instability
22
Q

What are some structural risk factors for neonatal seizures?

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A
  • IVH (Grade III-IV)
  • Cerebral malformations (e.g., lissencephaly, pachygyria)
23
Q

What are some genetic/other risk factors for neonatal seizures?

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A
  • Benign familial neonatal seizures
  • Fifth day fits
  • Benign sleep myoclonus
  • Drug withdrawal
24
Q

What are the types of neonatal seizures?

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A
  • Focal Clonic
  • Focal Tonic
  • Myoclonic
  • Spasms
  • Subclinical
  • Subtle
  • Absence
  • Atonic
  • Febrile
25
What is a distinguishing feature of jitteriness compared to seizures?
Jitteriness is stimulus-sensitive, seizures are not.
26
What are common lab tests for diagnosing neonatal seizures?
* Glucose * Calcium * Electrolytes * Ammonia * Blood gas * Sepsis workup
27
What imaging method is most sensitive for detecting seizures in neonates?
MRI
28
What is the gold standard for diagnosing seizures?
EEG/aEEG
29
What is the goal of seizure management in neonates?
Seizure-free or minimal seizures with tolerable side effects
30
What is the first-line pharmacologic treatment for neonatal seizures?
Phenobarbital
31
What are the adverse effects of phenobarbital?
* Sedation * Respiratory depression * Paradoxical hyperactivity * Vitamin D/K metabolism issues
32
What is the second-line treatment for neonatal seizures?
Phenytoin (Dilantin)
33
What is a common adverse effect of phenytoin?
* Gingival hyperplasia * Ataxia * Sedation
34
What is an alternative to phenytoin that is water soluble?
Fosphenytoin (Cerebyx)
35
What is a common off-label use of levetiracetam (Keppra)?
Used in neonates for seizures
36
What should be considered in refractory seizures?
Pyridoxine (Vitamin B6)
37
What is the recommendation for tapering AEDs in neonates?
Consider tapering after 3 months seizure-free
38
What is the long-term risk of epilepsy in neonates with seizures?
25%
39
What is the risk of neurologic sequelae in infants with seizures compared to those without?
40x higher
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