Controversies concerning neonatal seizures.

Five issues are discussed with respect to the diagnosis, etiology, treatment, prognosis, and pathogenesis of neonatal seizures. The presentation of a newborn with seizures represents a true emergency and frequently indicates significant neurologic dysfunction or damage to the immature nervous system. Despite the urgency to establish a diagnosis, several unique aspects of neonatal seizures impede prompt recognition. In addition, several etiologic possibilities may be associated with seizures. The efficacy of antiepileptic drugs and the prediction of outcome of patients with neonatal seizures are controversial. Experimental research in developing animals suggests both a selective vulnerability and resistance of the brains of immature animals subjected to neonatal seizures.