Convulsiones neonatales: diagnóstico y manejo

Abstract

The cause of neonatal convulsions is multifactorial, difficult labour, hypoxia, acidosis, hypercapnia, hypoglycaemia, hypocalcaemia, etc. Neonatal convulsions constitute a marker for neurological morbidity and the difficulty of control not only depends on the aetiology but is implicit in the prognosis of the child´s development. In the majority of cases the diagnosis and management is by clinical observation but nowadays it is well known the importance of EEG confirmation with polygrafic techniques and EEG video monitoring. This is essential for better identification and recognition of electrographic crises which could only be witnessed as, often impercible, autonomic changes. Without a doubt these techniques are fundamental in the evaluation and therefore prognosis of the child. We review the neurobiological basis of the crisis and the most useful classification for the clinical management. We analyze the most relevant aetiologies with a special mention of inborn errors of metabolism and guidelines for the therapeutic management of convulsions.