Perspective on Neonatal Seizures in Low- and Middle-Income Countries

Author(s): David Jonson

The most frequent neurological emergency is neonatal seizures, which have a negative impact on neurodevelopment. Although they are typically challenging to identify and cure, doctors in low and Middle Income Countries (LMIC) face a substantial clinical problem. The majority of them are triggered seizures brought on by an abrupt brain injury, such as Hypoxic-Ischemic Encephalopathy (HIE), an ischemic stroke, an intracranial hemorrhage, a central nervous system infection, or an abrupt change in metabolism. Less frequently occur early-onset epilepsy disorders. Since clinical signs of seizures in the neonatal period are often difficult to separate from nonseizure behaviour, clinical diagnoses of seizures are usually erroneous. Additionally, a significant portion of seizures have only electrical activity and no other clinical symptoms, necessitating an EEG or aEEG for diagnosis. Clinically, only focal clonic and focal tonic seizures can be identified with sufficient diagnostic assurance. Evidence suggests that early therapy enhances the response to anti-seizure medication, making prompt diagnosis and treatment crucial. Because so many published researches come from high-income nations and cannot be extrapolated to LMIC, it is critical to understand the etiologies, comorbidities, and medication trials assessing safety and efficacy in LMIC. The authors of this review study provide the most recent information on neonatal etiology, diagnosis, categorization, and management guidelines, with a focus on low-resource environments.