Seizures in Newborns: Causes, Signs & Treatment

Bringing a new baby home is a deeply joyful experience, but it can also come with moments of uncertainty and concern. Among the more distressing situations a parent may encounter is noticing unusual movements or behaviours that could suggest a seizure in a newborn. While this can feel overwhelming, understanding what is happening can make a meaningful difference in how you respond.

In newborns, the brain and nervous system are still developing rapidly, which means seizures may not look like the dramatic convulsions often seen in older children or adults. Instead, they can be subtle, brief, and sometimes difficult to recognise without careful observation. This is why awareness of early signs is so important.

With timely medical care and appropriate treatment, many newborns who experience seizures can recover well, especially when the underlying cause is identified early. In this guide, you will find clear, medically grounded information to help you recognise potential signs, understand possible causes, and know when to seek immediate medical attention.
 

A seizure is a sudden surge of abnormal electrical activity in the brain that briefly disrupts normal function. In a newborn, this disturbance can affect movement, behaviour, breathing, or awareness, depending on which part of the brain is involved. When such an event occurs within the first 28 days of life, it is referred to as a neonatal seizure.

In very young infants, seizures do not always appear as dramatic, full-body shaking. Because a newborn’s brain is still developing, these episodes are often subtle and may involve only one part of the body or present as small, repetitive movements. At times, they may resemble normal newborn behaviours, which can make them difficult to recognise without careful observation or medical evaluation.

Understanding this difference is important, as early identification and prompt medical care may help address the underlying cause and support better outcomes for your baby.

Identifying unusual movements in a newborn can be challenging. Babies naturally twitch during sleep, display a strong startle reflex, and often make sudden, jerky movements as part of normal development.

However, seizure symptoms in a newborn tend to follow certain patterns and may appear repetitive, persistent, or unusual for your baby. Being aware of these patterns may help you recognise when something is not typical.

1. Subtle Seizures

These are the most common type of seizures in newborns and are often easily missed because they can resemble normal behaviour.

These episodes may appear as small, repeated movements or changes in behaviour, such as lip-smacking, sucking, or chewing motions that continue without a clear reason. Some babies may show cycling or pedalling movements of the legs, or repeated rowing-
like motions with their arms. You might also notice unusual eye activity, including prolonged staring, frequent blinking, or the eyes rolling upward. In some cases, there may be brief pauses in breathing, sometimes accompanied by a bluish tint to the skin.

2. Clonic Seizures

Clonic seizures involve rhythmic, repeated jerking movements that occur at a steady pace. These movements may affect one part of the body, such as an arm, a leg, or one side of the face, rather than the whole body.

A key difference from normal newborn jitteriness is that these jerking movements tend to continue even if you gently try to hold or stabilise the affected limb. This persistence may help distinguish them from harmless movements.

3. Tonic Seizures

Tonic seizures are marked by a sudden and sustained stiffening of the muscles. During an episode, your baby’s body may become rigid, with the arms and legs extended or held in a fixed position.

You may also notice the back arching or the head turning to one side. Eye movements, such as rolling upward or sideways, can accompany this stiffness. These episodes may last for several seconds and can appear quite alarming.

4. Myoclonic Seizures

Myoclonic seizures present as very quick, sudden jerks or twitches of the muscles. These movements are typically brief but may occur repeatedly in clusters.

They can resemble an exaggerated startle reflex, but unlike a normal startle response, they happen without any obvious trigger such as a loud sound or sudden movement. Their repetitive and unprovoked nature is an important distinguishing feature.

Recognising these patterns early and seeking medical advice promptly may help ensure timely evaluation and care for your baby.
 

It is natural for parents to wonder what might trigger such distressing episodes. In most cases, a seizure in a newborn is not a condition on its own, but rather a sign that something is affecting the brain. Identifying the underlying cause is essential for guiding treatment and improving outcomes.

Some of the most common causes include:

• Lack of oxygen (Hypoxic-Ischaemic Encephalopathy or HIE): This is one of the leading causes of seizures in newborns. It occurs when the baby’s brain does not receive enough oxygen around the time of birth, which may happen due to complications involving the placenta, umbilical cord, or prolonged labour. Even a short period of oxygen deprivation can affect brain function.
• Infections: Serious infections acquired before, during, or shortly after birth may irritate or inflame the brain. Conditions such as meningitis or encephalitis, as well as viral infections like cytomegalovirus, herpes simplex virus, or rubella, may contribute to seizure activity in newborns.
• Metabolic imbalances: A baby’s body relies on a delicate balance of nutrients and minerals. Low blood sugar levels, reduced calcium, or low magnesium may disrupt normal brain activity and trigger seizures. These imbalances are often treatable once identified.
• Intracranial haemorrhage (bleeding in the brain): Bleeding within or around the brain can place pressure on delicate tissues and interfere with normal electrical signals. This is more commonly seen in premature babies, whose blood vessels are more fragile.
• Brain malformations: In some cases, the brain may not develop typically during pregnancy. Structural differences can affect how electrical signals travel, increasing the likelihood of seizures after birth.
• Drug withdrawal (Neonatal Abstinence Syndrome): If a baby has been exposed to certain medications or substances during pregnancy, they may experience withdrawal symptoms after birth. In more severe cases, this may include seizures along with irritability, feeding difficulties, and tremors.

Understanding these causes can help parents and healthcare providers work together to ensure timely diagnosis and appropriate care for the baby.

If a doctor suspects a seizure in a newborn, prompt evaluation is essential to identify the underlying cause and begin appropriate treatment. Because seizures in infants can be subtle, doctors rely on both careful clinical observation and specialised investigations to 
confirm the diagnosis.

Here are the main methods used:

• Electroencephalogram (EEG): This is considered the most reliable test for detecting seizures. Small, painless sensors are placed on the baby’s scalp to monitor electrical activity in the brain. An EEG can identify abnormal brain wave patterns, even when there are no visible physical signs of a seizure.
• Blood and urine tests: These tests help identify potential metabolic issues, such as low blood sugar or electrolyte imbalances, as well as infections or certain inherited conditions. They provide important clues about what may be triggering the seizures.
• Brain imaging: Imaging techniques such as cranial ultrasound, CT scans, or magnetic resonance imaging may be used to examine the structure of the brain. These tests can reveal bleeding, swelling, or developmental differences that might be contributing to seizure activity.
• Lumbar puncture (spinal tap): If there is concern about an infection like meningitis, doctors may collect a small sample of spinal fluid for testing. This helps detect bacteria or viruses that may be affecting the brain and nervous system.

By combining these approaches, doctors can build a clear picture of what is happening and tailor treatment to address the specific cause affecting the newborn.

Managing seizures in a newborn requires prompt, specialised care. Treatment typically follows two key steps: controlling the seizure activity and addressing the underlying cause. Most babies receive care in a Neonatal Intensive Care Unit (NICU), where they can be closely monitored by neonatologists and paediatric neurologists.

Treating the Underlying Cause

The first priority is to identify and correct the trigger behind the seizures. In many cases, once the root issue is treated, seizure activity may reduce or stop.

For example, if low blood sugar is detected, doctors may administer intravenous glucose to restore normal levels. If there are mineral imbalances, such as low calcium or magnesium, appropriate supplements are given. In cases where an infection is present, targeted treatment with intravenous antibiotics or antiviral medications may be started promptly to control the infection and protect the brain.

Anti-Seizure Medications

To stabilise abnormal electrical activity in the brain, doctors may use anti-seizure medications. These medicines help reduce or stop ongoing seizure episodes and prevent recurrence while the underlying cause is being treated.

Commonly used options in newborn care include phenobarbital, levetiracetam, and phenytoin. The dosage is carefully calculated based on the baby’s weight and condition, and the medical team monitors the baby closely to assess effectiveness and adjust treatment if needed.

Cooling Therapy (Therapeutic Hypothermia)

If seizures are linked to reduced oxygen supply during birth, a treatment known as therapeutic hypothermia may be recommended. This involves gently lowering the baby’s body temperature under strict medical supervision for a limited period.

Cooling therapy helps slow down metabolic processes in the brain, which may reduce inflammation and limit further injury. When used in appropriate cases, it can play an important role in improving long-term neurological outcomes.

With timely intervention and expert care, many newborns respond well to treatment, especially when the underlying cause is identified early.

One of the most common concerns parents have is whether early seizures will lead to long-term conditions such as epilepsy. While this is an understandable worry, the answer is often reassuring.

Epilepsy is a condition characterised by repeated, unprovoked seizures. In newborns, however, most seizures occur due to a specific and temporary cause, such as low blood sugar, an संक्रमण, or a short period of stress on the brain around birth. Once the underlying issue is identified and treated, the seizures often resolve completely. Many babies who experience seizures in the NICU go on to develop normally without any further episodes.

That said, the long-term outlook may depend on the cause of the seizures. If they are linked to more serious factors such as significant brain injury, prolonged lack of oxygen, or certain genetic conditions, there may be a higher chance of future neurological concerns, 
including epilepsy or developmental delays.

Ongoing care plays an important role in supporting your baby’s development. A paediatric neurologist may recommend regular follow-ups to monitor growth, assess developmental milestones, and identify any early signs of concern. In some cases, supportive therapies 
such as physiotherapy or occupational therapy may be advised to aid development.

With early diagnosis, appropriate treatment, and continued monitoring, many children go on to lead healthy and active lives.

Distinguishing between normal newborn movements and a potential medical emergency can be challenging. When in doubt, it is always safest to seek prompt medical attention.

You should seek emergency care immediately if your baby shows any of the following signs:

• Changes in colour: If your baby’s lips, face, or skin turn blue or unusually pale, it may indicate a lack of oxygen and requires urgent evaluation.
• Breathing difficulties: Pauses in breathing or irregular breathing patterns that last longer than a few seconds should never be ignored.
• Persistent rhythmic jerking: If you notice repeated, rhythmic movements that continue even when you gently hold the affected limb, this may suggest seizure activity rather than normal jitteriness.
• Unusual eye movements: Prolonged staring, repeated blinking, or eyes rolling upward or to one side can be important warning signs.
• Altered responsiveness or muscle tone: If your baby suddenly becomes very limp, unresponsive, or unusually stiff, immediate medical care is essential.

A helpful step for parents, if it is safe to do so, is to record a short video of the episode. Sharing this with your doctor can provide valuable insight and may help with quicker and more accurate diagnosis.

Facing the possibility of seizures in a newborn can feel overwhelming, but understanding the condition can bring a sense of clarity and control during a difficult time. While these episodes may appear alarming, many neonatal seizures are linked to temporary and treatable causes, and with timely medical care, outcomes are often positive.

Recognising early signs, seeking prompt medical attention, and following through with recommended treatment and monitoring can make a meaningful difference in your baby’s health journey. It is equally important to stay connected with your healthcare team, ask 
questions, and attend follow-up appointments to track your child’s development over time.

Every baby’s situation is unique, and progress may vary depending on the underlying cause. With attentive care, medical support, and patience, many children go on to grow and develop well. Trust your instincts, stay informed, and remember that you are not alone in navigating this experience.

Disclaimer: This article is for informational purposes only and does not substitute for professional medical advice. Always consult your paediatrician for any concerns about your baby’s health and medical needs.