Child Neurology Society's Brainstorm CNS Brainstorm Episode 35 "Neonate Status Epilepticus" with guest Dr. Justin Rosati
Mar 23, 2025
Dr. Justin Rosati, a neonatal neurologist from the University of Rochester, shares his expertise on neonatal seizures and status epilepticus. He discusses the challenges of recognizing subtle seizures in infants compared to older children. The conversation dives into the diverse causes of status epilepticus, emphasizing rapid genome testing's role in diagnostics. Dr. Rosati also highlights the pros and cons of amplitude integrated EEG in neonatal care and explores treatment strategies, including the role of phenobarbital and emerging options like IV lidocaine and ketamine.
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Neonatal Status Epilepticus Definition
- Status epilepticus is five minutes or more of seizure activity, or multiple seizures in five minutes without returning to baseline.
- Neonatal status epilepticus has a longer duration threshold (30 minutes) due to longer seizure durations.
Difficulty Identifying Neonatal Seizures
- Even neurologists struggle to differentiate subtle neonatal seizures (e.g., lip smacking, eye movements) from normal movements.
- A CNS meeting highlighted neurologists' difficulty in identifying seizures from videos of neonate movements.
Anticipating Next Steps in Seizure Management
- Anticipate next steps in status epilepticus management, considering potential delays in medication availability.
- Proactively discuss the next medication with the team to ensure timely administration.