Newborn staring up

Introduction Neonatal seizures can be manifested as binocular gaze, loss of consciousness, limb convulsions, lip cyanosis, etc., can be divided into febrile seizures and no heat convulsions, febrile seizures may be caused by intracranial infections, no febrile seizures may be neonatal hypoxia Ischemic encephalopathy and intracranial hemorrhage, hypocalcemia, etc. caused by hypocalcemia generally do not have sequelae, others may have sequelae: including epilepsy, cerebral palsy.

Cause

1. Perinatal complications: HIE, intracranial hemorrhage, brain damage.

2. Infection: Meningitis caused by various pathogens, encephalitis, brain abscess, infection with toxic encephalopathy, tetanus, high fever.

3. Metabolic factors: low blood calcium, low blood magnesium, low blood sodium, high blood sodium, hypoglycemia, alkalosis, vitamin B6 deficiency, nuclear jaundice, uremia.

4. Cerebral hypoxia: hyaline membrane disease, meconium aspiration syndrome, pulmonary hemorrhage, acute cardiogenic cerebral ischemia syndrome, hypertension, polycythemia, fever syndrome.

5. Brain abnormalities: congenital brain dysplasia, craniocerebral malformations, intracranial tumors.

6. Congenital enzyme deficiency: Maple diabetes, urea cycle disorder, hyperglycemia, propionateemia, methylmalonic acidemia, isovaleric acid, galactosemia, vitamin B6 dependence.

7. Familial: Benign familial epilepsy, adrenal white matter atrophy, neurocutaneous syndrome, Zellwegen syndrome, Smith-Lemli-Opitz syndrome.

8. Drugs: stimulants, isoniazid, aminophylline, local anesthetics, organic phosphorus, withdrawal syndrome.

9. The cause is unknown: about 3% of neonatal seizures.

It is worth noting that some children may have multiple diseases at the same time, such as hypoxic ischemic encephalopathy with hypocalcemia, hypomagnesemia or hyponatremia.

an examination

Related inspection

Fundus examination

Newborns have two eyes gaze, tremor, or blinking constantly, mouth repeatedly chewing, sucking movements, irregular breathing with skin bruising, facial muscles twitching, these are the performance of neonatal seizures.

Differential diagnosis

Differential diagnosis of gaze on both eyes of newborns:

Convulsions can be divided into two types: febrile seizures and no febrile seizures.

The most common ones with hot convulsions are:

1. Systemic infectious diseases: such as pneumonia, tetanus, sepsis, toxic bacillary dysentery, etc., high fever convulsions caused by acute upper respiratory tract infections, more common in infants and young children, generally as long as the high heat is relieved, convulsions can be alleviated, convulsions stop After the mind can return to normal.

2. Central nervous system infection diseases: such as epidemic meningitis, Japanese encephalitis, toxic encephalopathy, cerebral malaria, brain abscess and other convulsions, often manifested as repeated attacks, each attack time is longer, In a state of persistence, there is high fever, lethargy, paralysis, and coma after convulsions occur.

The most common ones without hot shock are:

1. Non-infectious central nervous system diseases: such as neonatal intracranial hemorrhage, cerebral hypoxia, brain tumors, craniocerebral trauma, brain hypoplasia, epilepsy, and various sequelae of encephalitis and meningitis. Most of them are accompanied by mental retardation, disturbance of consciousness, and abnormal motor function.

2. Non-infectious systemic diseases: such as hand and foot sputum deficiency of vitamin D, infantile spasm, hypoglycemia, uremia, diabetic acidosis, hypertensive encephalopathy caused by acute nephritis, and belladonna, organic phosphorus, carbon monoxide poisoning, etc. There can be horror.

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