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Začetek neonatalne nevrologije sega v 50. leta prejšnjega stoletja, ko se je z vrednotenjem nevroloških znakov izoblikovalo merilo normalnosti oz. optimalnosti delovanja osrednjega živčevja (OŽ) na eni strani in nenormalnosti na drugi. Sledil je razvoj slikovnih metod, ko je z ultrazvočno preiskavo postalo možno prepoznati krvavitev v možganske prekate in poškodbo bele možganovine – obprekatno cistično levkomalacijo; v nadaljevanju je magnetnoresonančno slikanje pomembno prispevalo k razumevanju kompleksnosti možganske poškodbe nedonošenega in donošenega novorojenčka. Razvoj elektroencefalografije je omogočil vpogled v zorenje OŽ ter odločilno prispeval k razumevanju narave neonatalnih konvulzij. Napredek bazične znanosti je pri-speval k razumevanju mehanizmov možganske okvare na celični ravni ter začetku nevroprotekcije. V današnjem času sta pri možganski poškodbi nedonošenčka v ospredju raziskovanje dismaturacije – procesa sekundarne okvare, ki jo sproži prezgodnje rojstvo ter iskanje dodatnih možnosti za nevro protekcijo. V prihodnosti v prvi vrsti pričakujemo izboljšanje ravni nevroprotekcije, dodaten razvoj genetskih preiskav in zdravljenja ter s tem razvoj t. i. personalizirane medicine.

Introduction: Seizures are one of the most common pathologies in newborns. Their incidence is 1.5-3.5/1000 for term infants and 10-130/1000 for preterms. The most common causes of seizures in term infants are hypoxic-ischemic encephalopathy (HIE), cerebrovascular insult (CVI), cerebral malformations (CM), and metabolic disorders. For preterm infants: intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL) and infections. Clinical characteristics are diverse and subtle, and subclinical forms are common. The drug of the first choice is phenobarbitone. Newborns with seizures are more prone to developing neurological disturbances such as epilepsy and cerebral palsy. Methods: This is a clinical, observational research, one-year, retrospective, cross-sectional study conducted in the Department of neonatal intensive care and neonatology of the Clinic of Pediatrics KCUS. The study included 43 newborns who met the inclusion criteria. Results: We found that 7.19% of hospitalized newborns had seizures. A number of seizures were recorded in the group of term infants with an earlier time of seizures. The most common etiological causes were: HIE, IVH, infections, and CM. There was a frequent occurrence of metabolic disorders such as acidosis, blood sugar, and mineral (Ca, K, Na, and Mg) disorders. The median of the first day of onset of seizures in full-term infants is on the fourth day, while in premature infants it is on the sixth day of life. Phenobarbitone was mainly used to stop seizures, with great success. Overall mortality in children with seizures was 37.21%. Conclusions: Seizures are common in newborns, which, depending on the etiological cause, increase mortality, especially in preterm infants. Seizures in term infants occur earlier than in premature infants. The most common etiology of seizures in term infants are infections, hypoxemic-ischemic encephalopathy, intracranial hemorrhage, cerebral malformations, and cerebrovascular insult. In premature infants these are hypoxemic-ischemic encephalopathy, intracranial bleeding, and infections. In the initial treatment of neonatal convulsions, phenobarbitone is most often used, which has proven to be successful in the majority of cases. [ABSTRACT FROM AUTHOR]

Neonatal convulsions may be the first, in some cases, the only clinical sign of neonatal central nervous system disorder. As such, they require prompt evaluation to determine the cause, as the underlying may have influential causes. Furthermore, since they may contribute to further brain injury, they require immediate treatment. Neonatal convulsions have unique clinical features and their presentation differs from convulsions in older children. They may include focal clonic, focal tonic, myoclonic and epileptic spasms. Furthermore, they may present with abnormal eye movements, lip smacking, swimming or pedaling movements, or apnea. Moreover, non-convulsive paroxysmal movements are also common in the neonatal population and are sometimes diffcult to distinguish from convulsions. Continuous electroencephalogram is the gold standard (cEEG) for the detection of neonatal convulsions. In addition to continuous electroencephalogram (cEEG), amplitude EEG (aEEG) is a useful bedside tool. Neonatal convulsions carry a high risk for early mortality, but are also a negative predictive factor for the development of motor and cognitive disorders and epilepsy. [ABSTRACT FROM AUTHOR]