====== 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}}