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Neurology 

Neurology
Chapter:
Neurology
Source:
ACoRN: Acute Care of at-Risk Newborns: A Resource and Learning Tool for Health Care Professionals (2 edn)
DOI:
10.1093/med/9780197525227.003.0005

The neurology chapter examines mild, transient, and more serious, underlying neurological conditions that present in the newborn period. Abnormalities of tone, activity, alertness, and movements (i.e., seizures) can occur in many neonatal conditions, some of which require immediate intervention. Assessments include testing infant tone and reflexes, the Encephalopathy Assessment Table, distinguishing jitteriness from seizure activity, and identifying seizure characteristics. Early identification of infants with hypoxic ischemic encephalopathy—a primary cause of neonatal encephalopathy—is essential and should prompt either thermoregulatory management (strict normothermia) or therapeutic hypothermia, providing specific criteria are met. Symptomatic hypoglycemia can have long-term neurodevelopmental consequences and must be treated emergently with intravenous dextrose solution. Anticonvulsant therapy should be initiated for seizures, even when the underlying cause is not yet determined. Diagnostic testing and differential diagnoses, such as neonatal abstinence syndrome or neonatal opiate withdrawal are considered. Three case scenarios follow care pathways for two unwell infants.

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