Benign Neonatal Convulsions Clinical Presentation

Updated: Feb 16, 2016
  • Author: Nitin C Patel, MD, MPH, FAAN; Chief Editor: Amy Kao, MD  more...
  • Print
Presentation

History

The history of a patient with benign neonatal convulsions should be free of suspicion of causative elements for neonatal seizures, such as prenatal or perinatal stroke, perinatal asphyxia, fever, persistent lethargy, pertinent maternal illness or drug abuse, signs of metabolic dysfunction, or neurologic abnormalities.

Other criteria that have been noted but may be of limited value are a lack of neurologic or genetic abnormalities in siblings or other family members or metabolic dysfunction of any cause. A 5-minute Apgar score less than 9 (see the Apgar Score calculator) has also been suggested but is almost certainly too stringent to require for diagnosis.

Diagnostic criteria have been suggested by Miles and Holmes [36] as well as Plouin [3] for both benign idiopathic neonatal convulsions (BINCs) and benign familial neonatal convulsions (BFNCs).

Suggested diagnostic criteria for benign idiopathic neonatal convulsions include the following [3, 36] :

  • Infants born after 39 weeks' gestation
  • Apgar score of 9 or more at 5 minutes, greater than 7 at 1 minute: Lower scores should not exclude the diagnosis if other criteria are met.
  • Presence of a seizure-free interval between birth and the onset of seizures
  • Clonic and/or apneic seizures
  • Negative findings on evaluation for alternative etiology
  • Normal developmental and intellectual outcome: These are largely determined in retrospect.
  • Lack of seizures beyond the neonatal period
  • Normal laboratory findings (including but not limited to metabolic studies, neuroimaging, and lumbar puncture) [46]

Suggested diagnostic criteria for benign familial neonatal convulsions are as follows [3, 36] :

  • Normal neurologic examination findings
  • Negative findings on evaluation for alternative etiology
  • Normal developmental and intellectual outcome: These are largely retrospective criteria.
  • Positive family history of newborn or infantile seizures
  • Onset of seizures during neonatal period or early infancy
Next:

Physical Examination

The physical examination findings should be normal during the interictal period. The neurologic examination should also be normal during this period.

Previous