Neonatal Seizures Differential Diagnoses

Updated: Jul 30, 2019
  • Author: Raj D Sheth, MD; Chief Editor: Stephen L Nelson, Jr, MD, PhD, FAACPDM, FAAN, FAAP, FANA  more...
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Diagnostic Considerations

Benign sleep myoclonus

The clinician should be familiar with this benign condition, in which rhythmic movements (which occur only during sleep) mimic seizures. The condition can be alarming and may occur focally during nonrapid eye movement (non-REM) sleep. Video EEG monitoring shows no electrographic seizures.


Jitteriness must be differentiated from seizures in neonates. Jitteriness is not associated with ocular deviation. It is stimulus sensitive (eg, triggered by stimulation or easily stopped with passive movement of the limb). The movement resembles a tremor, and no autonomic changes, such as tachycardia, are associated with it.

Seizures often are associated with ocular deviation and are not stimulus sensitive. Autonomic changes frequently accompany them. The movements are clonic, unlike the tremorlike movements of jitteriness.

Other conditions to consider in the differential diagnosis of neonatal seizures include the following:

  • Anoxia

  • Benign epilepsy syndromes

  • Mitochondrial cytopathies

  • Myoclonic epilepsy

  • Myoclonus

  • Organic acidurias

  • Pyridoxine-dependent epilepsy

  • Subarachnoid hemorrhage

  • Subdural hematoma

  • Tuberous sclerosis

  • Vein of Galen malformation

  • Viral encephalitis

  • Viral meningitis

Differential Diagnoses