Issue # 23: Neonatal seizures are weird...
Not all funny baby movements are seizures. And not all seizures have funny movements...
How are you doing? Hopefully keeping it all together, one glass ball at a time? I had an efficient, fun, few days, save for the delving into White Lotus rabbit holes. (Not proud of this, but actually bought a dress similar to one from Victoria Ratliffe’s wardrobe…)
Thanks to a strong push from our membership community, we started our series on neonatal seizures last week. (Join the lovely Feeder-Growers here, and watch a bunch of members-only videos, if you’re interested).
If you haven’t seen the video yet, check it out here:
Ideally, I would have had plenty of videos lined up to show you examples of the various seizures. But, as you can imagine, it’s very difficult to get clearance for anything medical in media. Instead, I’ll link to videos other educators have put on YouTube.
Examples of seizures below:
A tonic seizure (stiffening of an extremity/ several muscle groups)
A clonic seizure (classic, jerking movement. High EEG correlation with seizures)
Automatism (here with eye blinking and lip smacking initially, then develops into a clonic seizure involving legs). It’s a screenshot below, so clicking won’t work!
Another automatism (this one with ‘pedaling’ or bicycling’ of legs)
Tonic seizure + automatism (contraction of limbs, and eye deviation)
These are some of the references we used putting together the videos:
The ILAE classification of seizures and the epilepsies: Modification for seizures in the neonate. Position paper by the ILAE Task Force on Neonatal Seizures
Treatment of seizures in the neonate: Guidelines and consensus-based recommendations-Special report from the ILAE Task Force on Neonatal Seizures
Neonatal Seizures (review in NEJM)
Neonatal seizures: diagnostic updates based on new definition and classification
And a table summarizing all the different clinical presentations of seizures:
(This is a table from a great Pediatrics in Review article).
Look- if you take away one thing about seizures: realize they’re really difficult to diagnose without an EEG.
Here is the PDF summary of our video
And a few MCQs related to neonatal seizures:
We have a few more videos on neonatal seizures planned- so be on the look-out for those!
And the rest…
Have you listened to the podcast Something Was Wrong? In this season (23rd) they cover the murky prenatal care at one birthing center in Texas, but also examine different types of midwifery training. It’s super addictive!
We’re going to start highlighting comments we receive on the YouTube channel since we love them so much! (Sometimes they offer great constructive criticism and other times, they’re hysterically funny, educational or frankly, quite mean. But, this last week, they were just very, very kind):
The AAP recently published a policy statement on the importance of disclosing medical errors in pediatric practice. I think we’ll film a video on this (because it’s so important). But in a nutshell: disclose the mistake to families, and make institutional changes to prevent similar errors from occurring again.
After hearing SO much about the book, I just ordered The Let Them Theory by Mel Robbins. Apparently, reading it will allow us to ‘stop wasting energy on things (we) can't control.’ I mean, that could be really useful in the NICU!!
Anybody want to read it with me? And we’ll compare notes in a couple of weeks?
While you’re there, remember to check out our Amazon storefront. We added reference and non-fiction books as well as a few other NICU friendly items. If you purchase anything through the links, all commissions will go to a neonatal charity. (So have at it!)
We hope you’re enjoying this newsletter as much as we enjoy writing it. Let us know what’s on your mind these days?!
Stay healthy, and we’ll be back in your inboxes in 2 weeks,
Tala and Arianna
Loving these nuggets/newsletters and especially learning new NICU resources! Thank you! ❤️
I am also reading “Let them!”