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Etiologies of neonatal seizures

Etiologies of neonatal seizures
Acute provoked (symptomatic) Neonatal-onset epilepsy
  • Acute neonatal encephalopathy (includes classic hypoxic-ischemic encephalopathy, both ante- and intrapartum)
  • Arterial ischemic stroke
  • Cerebral sinovenous thrombosis
  • Extracorporeal membrane oxygenation
  • Congenital heart disease
  • Vein of Galen malformation
  • Giant arteriovenous malformation
  • Hypertensive encephalopathy
  • Intracranial hemorrhage (subdural subarachnoid, intraventricular, intraparenchymal)
  • Trauma (intrapartum and nonaccidental)
  • Infections (sepsis, meningitis, encephalitis)
  • Transient, simple metabolic disorders
  • Intoxication
  • Isolated cerebral dysgenesis (eg, lissencephaly, hemimegalencephaly)
  • Cerebral dysgenesis associated with inborn errors of metabolism
  • Chronic infection (TORCH [toxoplasmosis, other infections, rubella, cytomegalovirus, and herpes simplex] syndromes)
  • Neurocutaneous syndromes
    • Incontinentia pigmenti (Bloch Sulzberger syndrome)
    • Hypomelanosis of Ito
    • Sturge-Weber syndrome
    • Tuberous sclerosis complex
    • Linear sebaceous nevus (epidermal nevus syndrome)
  • Specific early-onset epilepsy syndromes
    • Self-limited (familial) neonatal epilepsy (SeLNE); "fifth-day fits"
    • Self-limited familial neonatal-infantile epilepsy (SeLFNIE)
    • Early infantile developmental and epileptic encephalopathy (EIDEE)
    • KCNQ2 developmental and epileptic encephalopathy (KCNQ2-DEE)
    • Pyridoxine-dependent developmental and epileptic encephalopathy (PD-DEE)
    • Pyridoxamine 5'-phosphate deficiency developmental and epileptic encephalopathy (P5PD-DEE)
Adapted from:
  1. Wusthoff CJ, Mizrahi EM, Clancy RR, Pestana Knight EM. Neonatal seizures and EEG. In: Wyllie's Treatment of Epilepsy: Principles and Practice, 7th Edition, Wolters Kluwer 2021.
  2. Zuberi SM, Wirrell E, Yozawitz E, et al. ILAE classification and definition of epilepsy syndromes with onset in neonates and infants: Position statement by the ILAE Task Force on Nosology and Definitions. Epilepsia 2022; 63:1349.
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