Affiliations: Fetal/Neonatal Neurology Programs, Rainbow Babies and
Children's Hospital, University Hospitals Case Medical Center, Case Western
Reserve University, Cleveland, OH, USA
Note: [] Correspondence: Mark S. Scher, MD, Rainbow Babies and Children's
Hospital, 11100 Euclid Ave., RBC 6090, Cleveland, OH 44106-6090, USA. Tel.: +1
216 844 7791; Fax: +1 216 844 8966; E-mail: Mark.Scher@UHhospitals.org
Abstract: Current advances in clinical and translational research bring into
sharper focus the importance of epidemiologic, neurobiologic and
pathophysiologic factors that contribute to neonatal seizure occurrence, and
potential consequences for subsequent neurologic deficits. Diagnostic and
therapeutic algorithms must integrate prenatal, peripartum and postnatal
contributions to neonatal seizures with or without the expression of neonatal
encephalopathy. Neonatal seizure classifications must consider time-dependent
vulnerabilities to injury from different etiologies in specific brain regions
as a function of gestational maturity. The design of therapeutic protocols for
neuroprotection must consequently consider both prenatal and postnatal
strategies for prevention as well as rescue and repair. Neonatal neurointensive
care programs need to integrate these protocols into the care paths of preterm
and/or full-term neonates who express neonatal seizures in the context of acute
and/or chronic brain disorders. A newborn with seizures represents a complex
phenotype of past, present and future risks for brain injury.
