Neonatal Seizures – What Causes Seizures in a Newborn, and Is a Seizure the Sign of Medical Malpractice?

Neonatal seizures are caused by abnormal and excessive electrical activity in the brain. Most seizures occur within the first week of a baby’s life, and they often are a result of a birth injury that transpired during delivery. The injuries causing seizures can be avoidable; thus when they occur, they may be a result of negligent care during the birth process.

If negligent care was administered during delivery, or if a doctor, nurse, or other medical personnel failed to address a neonatal seizure and your child suffered a permanent injury, your child may be entitled to compensation for the pain and suffering, damages, and other injuries that result (including healthcare costs, other expenses, and the long-term ramifications and consequences associated with a birth injury).

Call our office today to schedule a no-obligation, complimentary case evaluation with our experienced Berkley birth injury lawyers.

We can help in cases of suspected birth injury due to medical malpractice. We retain physicians and other medical experts to carefully review the medical charts and other matters associated with the cases of our clients. If it appears that medical malpractice likely occurred, we pursue healthcare providers for the full damages caused by their negligence.

We advance the costs of litigation (including paying for court and deposition costs, expert fees, and other costs and expenses incurred in advancing a case) – these costs are then typically repaid through a settlement or successful trial award. We represent clients in birth injury cases on a contingency fee basis, which means that we are only entitled to a fee if we are successful in obtaining compensation.

The Potential Long-Term Effects of Seizures

The outcome for babies who experience a convulsion depends on the type of seizure and the underlying cause. For some, the consequences can be short-lived and do not result in lasting health issues. However, prolonged and untreated newborn seizures can cause permanent brain damage due to oxygen deprivation and excessive brain cell activity.[1]

Further, over half of all infants who experience neonatal seizures will develop epilepsy, cerebral palsy, cognitive impairment, and other neurological disorders.[2] Thus, it is critical for physicians and healthcare personnel to administer rapid, specialized care in response to the critical events and circumstances that can result in seizures if not immediately addressed.

What Are Neonatal Seizures?

Neonatal seizures (also known as neonatal convulsions) are epileptic events that happen during the first hours of life, to 1-2 days of life, to the first week of life. They occur when abnormal electrical discharges in the brain produce conditions such as brain disturbances, convulsions, or impaired consciousness. Early seizures must be quickly addressed and treated, as they are not only a sign of significant brain injury, but they can also cause additional brain damage if left unmanaged

What Causes Babies to Have Seizures

Overall, 3 out of every 1,000 babies experience newborn seizures, many of which cause debilitating injuries.[3] Of this number, up to 1.4% of term infants and 20% of premature babies will experience seizures.[4]

The abnormal electrical discharges that result in seizures can be caused by various issues, including:

Hypoxia-ischemia. The most common cause of neonatal seizures is hypoxia-ischemia, a type of brain injury produced by a lack of oxygen before, during, or after birth. These convulsions are challenging to treat; however, they tend to abate after 3 to 4 days. Often therapeutic hypothermia (whole-body cooling) is given to treat damage from this condition..
Ischemic Stroke. Often babies with severe hypotension will experience strokes that lead to apnea (pauses in breathing).
Neonatal Infections. Meningitis, sepsis, Group B streptococci, cytomegalovirus, herpes, rubella, and other infections can result in seizures. In such cases, other signs and symptoms will typically be present.
Hypoglycemia. Hypoglycemia is common among babies with diabetic mothers, who are underweight, or who have hypoxia-ischemia. Prolonged seizures can cause permanent damage to the central nervous system.
Intracranial Hemorrhage. This condition occurs when blood pools in the brain and surrounding tissues. Surgical intervention may be needed to relieve pressure and drain blood.
Preeclampsia. Preeclampsia is a condition where a mother has untreated high blood pressure that restricts vessels providing blood to an infant.
Umbilical Cord Injuries. If a cord wraps around a baby’s neck, is compressed in the birth canal, or is impinged during delivery, vital blood, oxygen, and nutrients may not reach a baby.
Improper Use of Instruments. When delivery instruments such as forceps or vacuum extractors are incorrectly used, the risk of brain bleeds increases.
Tachysystole. Contractions (inducted by drugs such as Pitocin or Cytotec) can be so strong and fast that they present as an almost continuous contraction. Consequently, blood vessels in the womb are constantly impinged and compressed, cutting off blood circulation to the fetus.
Kernicterus. When jaundice goes untreated, bilirubin builds up in an infant’s blood to the extent that their liver is unable to filter the toxic substance. This often causes severe, permanent brain damage that results in cerebral palsy. Seizures can signify the presence of this condition.[5]

What Are the Different Types of Seizures?

Neonatal seizures can be challenging to diagnose because the convulsion may be brief and subtle. Further, some symptoms may mimic regular movements and behaviors of healthy babies. The following are the common categories and symptoms of newborn seizures:

Clonic Seizures. These typically result in jerking movements of the face, tongue, arms, legs, and other extremities.
Myoclonic Seizures. These seizures usually cause quick, single jerking motions, involving one arm, leg, or the whole body.
Subtle Seizures. Common among full-term babies, subtle seizures typically result in random or roving eye movements, staring, or eye fluttering; sucking, smacking, or chewing; pedaling-like movements of the legs; thrashing or struggling movements; or long breathing pauses (apnea).
Tonic Seizures. Tonic seizures are usually characterized by stiffening or tightening of the muscles; turning the head or eyes to one side; or bending or stretching one or more arms or legs.[6]

How Are Seizures Typically Diagnosed?

After taking a family history and performing a physical examination, physicians usually perform one or more of the following to diagnose a seizure and underlying conditions:

Electroencephalography (EEG)
Laboratory Testing (serum glucose, electrolytes, cerebrospinal fluid analysis, urine, and blood cultures)
Cranial Imaging (MRI or CT)

How Are Seizures Treated?

Treatment of neonatal seizures is primarily focused on the underlying disorder and secondarily on seizures. Depending on the condition, the following treatments may be utilized:

Low Serum Glucose (10% dextrose 1 mL/kg IV is given)
Hypocalcemia (1-% calcium gluconate 1 mL/kg IV is given; this dosage can be repeated for persistent seizures)
Hypomagnesemia (0.2 mL/kg of 50% magnesium sulfate is given IM)
Bacterial Infections (IV or oral antibiotics)
Herpes Encephalitis (Acyclovir)
Persistent Seizures (Pheobartital, Levetiracetam, Fosphenytoin, or Lorazepam can be administered)[7]

Can I Sue if My Child Experienced a Neonatal Seizure?

Yes, if medical personnel failed to provide the appropriate standard of care.

To avoid neonatal seizures, medical personnel must strictly follow standards of care. The infant and mother must be monitored, proper testing must be performed, and, if needed, appropriate treatment must be administered. Failure to properly perform these steps and to otherwise provide the appropriate standard of care is medical negligence. If a physician fails to recognize or address seizures after birth, and the underlying conditions go untreated, they could be liable for any harm suffered by the infant.

If your child was diagnosed with brain damage or seizures after birth, it is vital to have all medical records reviewed to determine whether negligence played a role in causing the injury. Our birth injury lawyers have over two decades of experience in successfully representing birth injury and neonatal seizure victims.

We invite you to contact our firm for a free consult. If it appears that a birth injury may have occurred through medical malpractice, we will review your case with medical experts (including physicians) who can advise as to whether, in their professional opinion, medical malpractice in fact occurred. There is no cost for this expert review, even if your case is not accepted. During this process, we can also explain your options, and if your case is accepted, we will tenaciously fight for every dollar that your child and family rightfully deserve.

[1] Neonatal Seizures, Benioff Children’s Hospital, https://www.ucsfbenioffchildrens.org/conditions/neonatal_seizures/#:~:text=Causes,compression%20of%20the%20umbilical%20cord.

[2] Neonatal Seizures, Benioff Children’s Hospital, https://www.ucsfbenioffchildrens.org/conditions/neonatal_seizures/#:~:text=Causes,compression%20of%20the%20umbilical%20cord.

[3] Neonatal Seizures and Neonatal Syndromes, NCBI, https://www.ncbi.nlm.nih.gov/books/NBK2599/#:~:text=Neonatal%20seizures%20or%20neonatal%20convulsions,the%20first%20week%20from%20birth.

[4] Neonatal Seizure Disorders, Merck Manual, https://www.merckmanuals.com/professional/pediatrics/neurologic-disorders-in-children/neonatal-seizure-disorders.

[5] Neonatal Seizure Disorders, Merck Manual, https://www.merckmanuals.com/professional/pediatrics/neurologic-disorders-in-children/neonatal-seizure-disorders.

[6] Neonatal Seizures Signs and Symptoms, Benioff Children’s Hospital, https://www.ucsfbenioffchildrens.org/conditions/neonatal_seizures/signs_and_symptoms.html

[7] Neonatal Seizure Disorders, Merck Manuals, https://www.merckmanuals.com/professional/pediatrics/neurologic-disorders-in-children/neonatal-seizure-disorders.