An electroclinical pattern characteristic of benign familial neonatal convulsions is reported in two neonates with non-benign seizures treated at the Miami Children’s Hospital, FL. Ten seizures recorded by continuous video-EEG telemetry began with generalized tonic posturing and diffuse attenuation of EEG activity. Bilateral clonic movements that followed were accompanied by repetitive sharp waves or spikes. None had a family history of seizures, and one patient followed for 5 years had speech delay, hypotonia, hyperreflexia, and autistic behavior. The cause of seizures was undetermined. [1]

COMMENT. The electroclinical events thought to be characteristic of benign familial neonatal convulsions (BFNC) are nonspecific. BFNC is heterogeneous in clinical and EEG features and cannot be distinguished from benign infantile familial convulsions on the basis of clinical seizure patterns. (see Progress in Pediatric Neurology III, 1997;pp8-9).

Outcome of neonates with electrographically identified seizures was correlated with background EEG and number of independent seizure foci in a study of 53 neonates at Sydney Children’s Hospital, Australia [2]. A severely depressed EEG background in a neonate with seizures or at risk of seizures was correlated with mortality during the first month, and frequent neonatal independent seizure foci correlated with poor outcome at 1 year.