Benign nonfamilial neonatal seizures [ICNApedia]

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====== Benign nonfamilial neonatal seizures ======
Benign neonatal seizure (nonfamilial) is a benign syndrome characterized by clonic seizures that begin around the fifth day of life and may recur during the following 2 to 3 days.

===== History & terminology =====
  * Dehan et al 1977[(:cite:931532>{{pmid>long:931532}})] first reported a neonatal convulsive disorder of unknown etiology that occurs around the fifth day of life and associated with a favorable outcome.
  * Prior & Macourt (1981)[(:cite:7305412>{{pmid>long:7305412}})] described the features in 90 infants with the condition and coined the term "fifth day fits"
  * In 1989, the ILAE Commission on Classification and Terminology proposed the term "benign neonatal seizures"
  * The [[content:epilepsy_classification|updated ILAE 2017 classification]] categorizes it under //Conditions with epileptic seizures that are traditionally not diagnosed as a form of epilepsy per se//.
===== Genetics =====
  * Claes et al 2004 reported three de novo mutations in KCNQ2 in 4 patients with benign neonatal seizures without a family history (Claes et al 2004). 
  * Ishii et al 2009 also reported another de novo mutation was reported in a neonate with benign neonatal seizures and no family history of seizures.
  * KCNQ2 variants have been described in patients with benign familial neonatal seizures suggesting an overlap between the 2 syndromes.
===== Clinical features =====
  * seizures are mainly clonic
  * median duration is around 20hrs (status epilepticus)[(:cite:panayiotopoulos2005>)]
  * onset is around fifth day of life
===== EEG =====
  * ictal EEG usually shows localised spikes
  * interictal EEG usually shows theta pointu alternant. It may also show focal or multifocal, non-specific abnormalities or a discontinuous pattern or it may be normal in ~10%.
===== Pathophysiology =====
  * probably environmental
===== Differential diagnosis =====
  * [[content:benign_familial_neonatal_epilepsy|Benign familial neonatal epilepsy]]
  * [[content:benign_familial_infantile_epilepsy|Benign familial infantile epilepsy]]
  * [[Benign infantile epilepsy]]
===== Prognosis =====
  * excellent with risk of subsequent seizures practically nil(0.5%)[(:cite:panayiotopoulos2005>Panayiotopoulos CP. (2005). **The Epilepsies: Seizures, Syndromes and Management**. Oxfordshire (UK): Bladon Medical Publishing)]
  * normal neurodevelopmental outcome
===== References =====
~~REFNOTES~~
{{tag>neonatal_seizures}}