Symptomatic neonatal seizures. Observations on ILAE classification of neonatal seizures based on recordings of 95 consecutive newborns with EEC-confirmed neonatal seizures

Four syndromes of neonatal seizures are accepted into the International Classification of Epilepsies, Epileptic Syndromes and Related Disorders (1LAE, 1989) as "generalized idiopathic and symptomatic syndromes". Moreover most newhorns with neonatal seizures (NS) are clsssified as epilepsies and syndromes "undetermined whether focal or generalized" and seizures are generally symptomatic of a critically ill condition: in such a situation prognosis is not well understood. On examining data from 95 consecutive newborns with EEG-confirmed NS observed between 1989 and 1999, we discuss about 1LAE classification of NS considering post-natal epilepsy and outcome for newborns with symptomatic NS. Epilepsy occured in 31 of 70 newborns with symptomatic NS surviving the neonatal period. More than half of newborns with NS are not epileptic and should be classified as "situation-related seizures or status epilepticus". An unfavourable outcome was found in 90f/c of infants with epilepsy (vs. 30Vc of infants without). NS related to cerebral dysgenesis or to a cryptogenetic condition seems to be strictly associated with the occurence of epilepsy. Among symptomatic NS, the diagnosis of a truly neonatal epileptic condition, compared with a symptomatic seizuring condition, may suggest a more correct therapeutic management of NS.