Expertise

There are few things as terrifying for a new parent than watching their baby seize for the first time. Depending on the type of seizure an infant experiences, they may go limp, experience tremors, or display muscle spasms. 

Watching your child enter into an altered state of consciousness or seeing them lose control of their body is acutely frightening. But when the seizure is over and you begin to wonder what might have caused it, you may discover you have much more to worry about.

A seizure in an infant is most likely the effect of brain damage from a traumatic childbirth, a congenital birth defect, or an infection. Whatever the cause, all infant seizures are the result of abnormal electrical signals in the brain that may indicate a birth injury and/or cause additional injuries to the newborn.

Seizures in newborns.

What types of seizures could a newborn experience?

There are a variety of ways to categorize seizures depending on the part of the brain that is affected and/or the symptoms of the seizure. Previously referred to as either “petit mal” seizures or “grand mal” seizures, the medical community now divides them into partial seizures or generalized seizures.

Partial seizures include:

• Simple focal seizures - usually involving the occipital lobe at the back of the head. These seizures cause muscle spasms in isolated muscle groups. They can also cause autonomic, somatosensory, or psychic symptoms.
• Complex focal seizures - abnormal electrical messages in the temporal lobe of the brain cause the infant to lose consciousness or experience impaired consciousness.

Generalized seizures include:

• Subtle seizures - the most common type of newborn seizure, the infant may experience changes in breathing patterns or facial movements, brief rigidity or moments jerking, inability to focus eyes, become less alert. 
• Atonic seizures - cause a sudden loss of muscle tone that creates limpness and usually results in a non-responsive state.
• Tonic seizures - which cause muscles to become rigid and stiff.
• Myoclonic seizures - the infant twitches or jerks a part or all of their body.
• Clonic seizures - the infant experiences convulsions (rhythmic jerks or shakes).
• Tonic-clonic seizures - rigidity is followed by convulsions. 
• Infantile spasms - occurring in infants under six months of age, as the baby falls asleep or wakes up (s)he may experience sudden spasms in a part or all of the body.

What causes newborn seizures?

Seizures are most common in the first year (and especially the first month) of an infant’s life. Pre-term babies and babies with low birth weights are also at a higher risk for experiencing seizures. Although some seizures may be caused by genetics or issues with metabolism (low levels of calcium, magnesium or glucose in the blood), birth injuries are a major cause of this condition:

• Fetal stroke, a disruption of blood flow to the brain between 14 weeks after conception and the onset of labour, can cause postnatal epilepsy and Cerebral Palsy-related seizures. Perinatal strokes, which occur later in pregnancy (at about 20-22 weeks of pregnancy to the end of the first month after birth), are more common. And the risk of stroke is likely greatest in the week surrounding delivery.
• Oxygen deprivation during labour, delivery, and in the period immediately following birth is likely the most common cause of brain injury during childbirth. Unlike strokes which generally occur in one half of the brain, hypoxia and ischemia cause cell death, damage in the entire brain and cerebral dysplasia or dysgenesis.
• Head trauma during or immediately after the delivery can also result in brain damage and seizures. Most often this trauma occurs during difficult births where extraction devices such as vacuums or forceps are used to pull the baby out. When used improperly or if too much force is exerted, these instruments can cause skull fractures, hydrocephalus and hematomas.
• Postnatal infections such as meningitis or encephalitis can also cause seizure-related brain damage. Group B strep is an especially common maternal infection that affects as many as one in four pregnancies and is strongly linked to seizures. Untreated infections in newborns that result in fevers increase the risk of seizures.

How are infant seizures diagnosed?

Different types of seizures are often linked to different causes or syndromes. Partial seizures tend to be caused by an injury as a result of brain damage while idiopathic epilepsy syndromes tend to cause generalized seizures. More than three in four children who have seizures have experienced more than one type, and one type of seizure can progress to a different type over the course of a child’s life.

To determine what injury or condition is causing the seizures, a doctor may perform an electroencephalogram (EEG) to measure electrical activity and impulses in the brain. Multiple EEGs may be required for the doctor to observe what brain activity looks like between seizures. When EEGs appear normal, magnetic resonance imaging (MRIs) or computerized tomography (CT) may be used to determine if structural damage or obstructions are causing the seizure.

Treating infant seizures.

Treating neonatal seizures depends on the type, age of onset, cause and whether the child has other medical conditions. If the baby experienced a lack of oxygen during delivery (hypoxic ischemic encephalopathy), they may undergo hypothermic treatment to cool the brain and body for several hours or days following the adverse event. Cooling the brain and body has been found effective to limit brain damage in some cases. 

If the seizures are thought to be epileptic episodes, anticonvulsants may be prescribed. These include:

• Phenobarbital.
• Phenytoin.
• Clonazepam.
• Zonisamide.
• Stiripentol.
• Carbamazepine.  
• Levetiracetam.
• Lamotrigine.
• Sodium valproate.
• Vigabatrin. 
• Pyridoxine.

Some types of seizures may become less frequent or disappear with age, while others remain a life-long affliction.

Should I consult a birth injury lawyer?

Many types of seizures are evidence of a brain injury. Asking how this injury occurred and whether it could have been prevented are the first steps in determining whether another person’s negligence caused or contributed to this tragic situation.

If you believe your baby’s seizures are related to a complicated and challenging delivery, improper or insufficient prenatal or postnatal care, other actions or inaction on the part of your doctor, midwife, or other medical providers, they may be liable for damages for your losses and you might want to contact a medical malpractice lawyer.

Medical professionals must adhere to standards of care which are designed to minimize risks of adverse outcomes. For obstetrics, these include: 

• Careful monitoring of maternal and fetal health during pregnancy, and following up on any abnormalities.
• Screening an expectant mother for conditions which pose a risk for a vaginal delivery, including maternal infections such as StrepB.
• Monitoring the fetus for signs of stress during labour, and acting decisively if a caesarean section is needed.
• Using appropriate care if pulling the baby from the birth canal or using equipment such as vacuums or forceps.
• Checking for signs of complications after birth, such as meconium aspiration syndrome and monitoring for signs of infection.

Mistakes can happen and medical professionals are not held to a standard of perfection. But if their negligence has caused your baby serious harm, you should be able to receive compensation and damages for all that you’ve lost.

Gluckstein Personal Injury lawyers can help.

When you contact a member of our brain injury lawyers team for a free, no obligation consultation, you will soon see that Gluckstein Personal Injury Lawyers cares about you and your family beyond a potential legal case. As a firm committed to providing full-circle care, we want to do whatever we can to help your child live his or her best life possible, and to help you and your family heal from this trauma.

After listening to your story with empathy and interest, we will explain your rights and outline some of the ways you may choose to proceed. If you decide to pursue a medical malpractice suit with us, we will take time to ensure you understand the process. When we take on a case, we believe we stand a good chance at success. That’s why we only get paid if we help you achieve a settlement or court award. We cover the costs as we pursue justice for you.

If you want a sense of closure as you and your family move forward on a journey to healing, contact Gluckstein Personal Injury Lawyers to learn how we can help.