Can a newborn experience seizures in sleep?

Yes, seizures can take place when a newborn sleeps or is awake. Some seizures can go unnoticed since they comprise slight and involuntary movements and behaviour changes. It is vital to consult a doctor about any movements that seem odd during sleep.

Is it possible to experience seizures that involve no visible movements?

Yes, neonatal seizures can occur without visible movements. These are called subtle or electrographic seizures and may involve changes in heart rate, breathing, eye movements, or brain activity alone. EEG monitoring helps doctors detect seizures that are not externally noticeable.

Will seizures affect the newborn brain development?

Neonatal seizures may affect brain development depending on their cause, severity, and duration. Early diagnosis, appropriate treatment, and regular developmental monitoring can help improve outcomes.

Neonatal Seizures: Signs, Causes, Diagnosis and Treatment

The first few weeks of a baby's life bring many changes as parents learn to recognise their newborn's movements and behaviour. While most movements are normal, certain unusual or repetitive actions may indicate an underlying medical concern.

One such instance is neonatal seizures, which can be challenging to identify because they do not always cause visible shaking. Dr Abhishek Chopra, Senior Consultant Neonatologist and Paediatrician at Cloudnine Group of Hospitals, Punjabi Bagh, New Delhi, explains the signs and importance of timely medical care.

What Are Neonatal Seizures?

Neonatal seizures are episodes of abnormal electrical activity in the brain that occur during the first 28 days after birth. They may indicate an underlying neurological, metabolic, or infectious condition.

Unlike seizures in older children, neonatal seizures do not always involve noticeable shaking or vigorous body movements. Some episodes produce subtle signs that parents may find it difficult to recognise. Therefore, any unusual, repetitive movement or unexplained change in a newborn’s behaviour should be assessed by a doctor.

What Causes Neonatal Seizures?

Common causes include the following:

Oxygen deprivation during birth: Reduced oxygen supply to the brain during or right after birth can cause brain injury and seizures
Stroke: A disruption in blood flow to a part of the baby's brain may trigger seizure activity
Brain infections: Conditions such as meningitis and encephalitis can affect brain function
Low blood glucose: Insufficient glucose can interfere with the brain's normal functioning
Electrolyte disturbances: Abnormal levels of sodium, calcium, or other electrolytes may trigger seizures
Brain development abnormalities: Structural differences in the brain can contribute to seizure activity
Genetic conditions: Certain genetic disorders can affect brain function and increase seizure risk

Early recognition, prompt diagnosis, and appropriate treatment are essential to protect a newborn's neurological health.Dr Abhishek Chopra, Senior Consultant Neonatologist and Paediatrician at Cloudnine Group of Hospitals, Punjabi Bagh, New Delhi

What Are The Signs of Neonatal Seizures?

The signs of neonatal seizures can vary depending on the part of the brain involved. Parents should watch for the following signs:

Repetitive jerking movements: Repeated twitching or jerking of the arms, legs, or other body parts
Unusual stiffening: Sudden stiffening of the baby's body or limbs without an obvious reason
Rhythmic movements: Repeated movements of the arms or legs that follow a regular pattern
Repeated eye deviation: The eyes repeatedly turning to one side or showing unusual movements
Changes in breathing: Sudden, unexplained pauses, or alterations in the baby's breathing pattern
Repetitive facial movements: Repeated movements of the mouth, lips, or face that appear normal

Not every unusual movement indicates a seizure. For example, newborns can experience normal startle reflexes and sleep-related movements. However, parents should not attempt to distinguish seizures from normal movements without medical guidance.

How Are Neonatal Seizures Diagnosed?

Depending on the symptoms and clinical state of the baby, Dr Abhishek Chopra may suggest the following tests:

Electroencephalography (EEG): Captures the electrical activity of the brain, which helps reveal fits, including those without visible shaking
Blood tests: Measure sugar, electrolyte levels, and other factors so that any metabolic defects can be diagnosed
Brain imaging: Ultrasound scans or MRI can determine structural defects, stroke, or injury in the brain
Tests for infections: More tests are done in case of a suspected brain infection or any other type of infection

How Are Neonatal Seizures Treated?

The treatment options are usually determined by the root cause of the condition, the state of the baby, and the types of seizures experienced.

Options may include the following:

Antiepileptics: Medication may be used to help stop the seizures
Treatment of metabolic issues: Conditions like hypoglycemia (low blood sugar levels) and electrolyte imbalance might be treated
Supportive care: Babies may receive breathing support, fluids, and temperature regulation in the neonatal intensive care unit (NICU)
Continuous monitoring: EEG monitoring helps doctors assess brain activity and determine whether seizures have stopped

What Should Parents Do if a Newborn Has a Seizure?

Suspected neonatal seizures require immediate emergency medical assessment. Parents should take the following precautions:

Seek emergency medical care immediately
Do not restrain the baby's movements
Never place fingers or objects inside the baby's mouth during an episode
Do not give food, milk, or oral medication during the episode
If possible, note the movements, the duration, and any changes in breathing to share with the medical team

Neonatal seizures can be worrying for parents, but early diagnosis and appropriate treatment can help improve outcomes. Recognising unusual movements, repeated jerking, changes in breathing, or sudden changes in responsiveness can help parents seek timely medical care. Since some seizures are difficult to recognise, any unusual behaviour in a newborn should be assessed by a doctor. Follow the recommended treatment plan and attend regular follow-up appointments to monitor your baby's development.

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FAQs on Neonatal Seizures: What Parents Should Know

Can a newborn experience seizures in sleep?
Yes, seizures can take place when a newborn sleeps or is awake. Some seizures can go unnoticed since they comprise slight and involuntary movements and behaviour changes. It is vital to consult a doctor about any movements that seem odd during sleep.
Is it possible to experience seizures that involve no visible movements?
Yes, neonatal seizures can occur without visible movements. These are called subtle or electrographic seizures and may involve changes in heart rate, breathing, eye movements, or brain activity alone. EEG monitoring helps doctors detect seizures that are not externally noticeable.
Will seizures affect the newborn brain development?
Neonatal seizures may affect brain development depending on their cause, severity, and duration. Early diagnosis, appropriate treatment, and regular developmental monitoring can help improve outcomes.