[Convulsions and epileptic syndromes of the newborn infant. Forms of presentation, study and treatment protocols].

OBJECTIVE

To review the different forms of presentation of convulsions and epilepsies in the newborn, and to establish a protocol for diagnosis and treatment.

METHODS

To achieve this we reviewed the literature and our own series over the past 15 years of 179 newborn babies with convulsions.

CONCLUSIONS

We present the results of the etiological analysis of neonatal convulsions. Then we discuss a protocol for diagnosis and treatment of this condition, with particular emphasis on diagnostic methods according to their complexity. The different therapeutic options are considered using a protocol for treatment that starts with the use of phenobarbital, pyridoxine, biotin, folinic acid, intravenous sodium valproate, diphenylhydantoin, clonazepam, lidocaine + phenobarbital and if the convulsions persist thipentone. Finally, we analyze the duration of treatment and emphasise that after discharge from the unit, only convulsions persisting after the neonatal period or accompanied by severe electroencephalographic changes should be treated. Finally we evaluate the high morbi-mortality (48% and 20% respectively) of the neonatal convulsions seen in our series. This is mainly due to the fact that the population studied corresponded to a tertiary level hospital covering a large area with conditions of risk.