Rhythmic Lingual Movements in Neonates: EEG Confirmation of Suspected Seizures

Abstract

ABSTRACT.Although rhythmic tongue movements may be seen in asymptomatic newborns with tactile stimulation or nonnutritive sucking during sleep, this movement may also represent a suspected clinical seizure in the sick neonate. Lingual movements are included in the category of “subtle” neonatal seizures that can commonly involve facial musculature. Rhythmic lingual movements were noted in twelve neonates (nine preterm, three full-term) who were suspected of having seizures. EEG recordings during these lingual movements documented coincident electrographic seizures in only two patients, while lingual myoclonus and/or tremor appeared in ten patients. Lingual myoclonus usually appeared in the context of multifocal myoclonus. Ten patients had documented cerebrovascular lesions on CT scan or autopsy. Only two of the six survivors are neurologically normal. Lingual movements in the newborn may represent a movement disorder as well as a seizure, and both may be indicative of severe neurological dysfunction on eit...