Neonatal seizures: eyes open or closed?

PURPOSE

It has been shown that persistent eye closure during paroxysmal events in infants makes seizures unlikely. Our study aims to assess whether this is also true in neonates.

METHODS

We reviewed and classified all archived neonatal seizures in our video database, considering electroclinical seizures only and excluding electrographic seizures and clinical seizures without ictal change in EEG. We assessed whether eyes were open during the seizure. One hundred and thirty-one electroclinical seizures (clonic, focal and generalized tonic, tonic-clonic, generalized myoclonic, subtle and spasms) in 46 neonates were included.

RESULTS

In 115 (88%) seizures, eyes were open; in 10 seizures, they were closed; and in six seizures, eye opening could not be evaluated. All 10 seizures with persistent eye closure were clonic seizures.

CONCLUSIONS

Our data demonstrate that persistent eye closure during an event suggestive of a seizure in a newborn makes an electroclinical seizure unlikely.