Seizures in newborns

Seizures in newborns: What parents need to know

Seizures in a newborn infant are always an emergency situation that requires immediate medical attention. Unlike seizures in older children, in infants they can appear very atypical, and they are easy to miss or confuse with normal movements. Understanding how seizures may look and knowing the correct action algorithm are critically important.

How do seizures appear in newborns?

Seizures are a manifestation of abnormal electrical activity in the brain. Because the newborn’s brain is still immature, seizures are rarely generalized (with jerking of the whole body) as in adults. They are often subtle (hidden) and may present as:

• Repetitive movements resembling sucking, chewing, “pedaling” with the legs or “swimming” with the arms.
• Unusual eye movements: rolling, rhythmic blinking, prolonged stare at a single point.
• Brief pauses in breathing (apnea).
• Sudden change in muscle tone: the body may become overly tense or, conversely, “floppy”.
• Less commonly — rhythmic jerking of one limb or half of the body.

The key difference between seizure movements and normal ones is their stereotypy, repetitiveness, and the fact that they are unable to be stopped by picking up the baby or changing the position of a limb.

Possible causes of seizures

Seizures in newborns are not a disease but a symptom that may indicate serious central nervous system problems. The most common causes:

• Hypoxic-ischemic encephalopathy (HIE): Brain injury due to oxygen deficiency during difficult deliveries.
• Infections: Meningitis, encephalitis, sepsis.
• Metabolic disturbances: Sudden drop in blood sugar (hypoglycemia) or calcium levels.
• Intracranial hemorrhages.
• Congenital brain developmental anomalies.

What should parents do?

If you suspect seizures in your child, your action algorithm should be clear:

1. Call emergency services immediately.
2. Ensure the baby’s safety: place them on their side on a flat surface, away from hard objects. Do not try to force the jaws apart or insert anything into the mouth.
3. If possible, record the episode on video for the doctor.

Diagnosis and treatment of seizures are performed exclusively in a hospital setting. Read about other neurological symptoms and newborn health on our website.