Newborn Neurological Disorders

Neurological disorders in newborn babies present significant challenges for both the babies and the families of the affected infants. The disorders can be caused due to problems in the brain, spinal cord, peripheral nerves, and muscles. The disorders can be congenital and may exist at birth or may develop after birth. Understanding the nature of neonatal neurological disorders, their causes, and treatments can facilitate early intervention and effective management for the best possible outcomes in these infants.

What are Neonatal (birth to 1 month of life) Neurological Disorders?

The foundation for your baby’s brain development begins during the first month after conception. Then the development continues during pregnancy and till around two years after birth. Any disturbance during formation or factors that can cause damage to the developing brain during pregnancy, during birth and first month of lifelead to neurological disorders in the neonate.

Newborn Neurological Disorders Diagnosis & Treatment in India, Hyderabad

 Types of Neonatal Neurological Disorders

Several serious neurological issues may affect a baby. Some of the most common include:

1. Seizures: A seizure is a transient occurrence of symptoms resulting from abnormal nerve electrical activity in the brain. Neonatal period is the period of of life with highest risk of having seizures. Common public knowledge of seizure is that shaking movements of whole body associated with fall, tongue bite and frothing occur. But due to immature brain and poor connections neonatal seizures are mostly subtle with rhythmic jerking of the limbs, but even more subtly, repetitive chewing movements or abnormal eye movements. Seizure is a symptom just like fever and the underlying causes can be many. The underlying causes of neonatal seizures include hypoxic-ischemic encephalopathy, intracranial hemorrhage, infections, or metabolic disturbances.
2. Encephalopathy: This indicates that overall alertness of the neonate baby is low due to any cause. Neonatal seizures can be the cause or effect of the problem. Inneonates, encephalopathy can be associated with lethargy, irritability, poor feeding, and respiratory distress. Common causes of this condition include hypoxic ischemia, infections, and metabolic disorders.
3. Intracranial hemorrhage: It is the bleeding within the various components of the brain. The common one in premature babies is intraventricular hemorrhage. Intracranial hemorrhage in neonates can be a result of birth trauma, prematurity, or vitamin K deficiency. The infant may appear very subtle behaviorally to having seizures along with increasing head circumference. It requires immediate medical attention for the management of bleeding and prevention of further damage.
4. Congenital neurological defects: These are disorders with malformation of nervous system while it is being formed. Investigating and treating the underlying cause like hydrocephalus and neural tube defects can be curative.
5. Birth asphyxia: This is a condition wherein there is an inadequate amount of oxygen supplied to the baby before, during, or shortly after birth. This the most common cause of neonatal seizures in developing countries. Birth asphyxia is said to cause serious damage to the brain if not attended to quickly enough. It can also result in hypoxic-ischemic encephalopathy, characterized by a low flow of oxygen in the brain. Therapeutic hypothermia—that is, lowering the body temperature of the baby—may help decrease cerebral injury and the chances of poor outcomes.
6. Periventricular leukomalacia: This is one of the most common conditions in infants who are born prematurely. It is the injury to the white matter that is located adjacent to the ventricles in the brain. In periventricular leukomalacia, small areas of the brain tissue in the vicinity of the ventricles die due to oxygen deprivation. This condition may be caused by low blood flow or inadequate supply of oxygen to the brain. PVL has the potential to cause developmental delays and can also cause motor impairment. Thus, early interventions are necessary. This doesn’t present in newborn period.
7. Hypotonia: This is characterized by low muscle tone or flaccidity, which creates problems with breathing and feeding. This can be the result of various neuromuscular problems. The causes of hypotonia in newborns can range from genetic disorders or brain damage to neuromuscular conditions. The condition can affect the movement, feeding, and breathing of the baby. Treatment depends on the underlying cause.
8. Cerebral metabolic disorders: The brain functions due to various biochemical reactions. The abnormalities in these pathways give rise to neurological dysfunction, some of which are reversible and some are not reversible. Metabolic disorders like phenylketonuria and maple syrup urine disease affect the brain. These disorders usually need specific dietary manipulation and medical interventions to prevent neurological consequences.

Etiology and Risk Factors for Neurological Disorders in Neonates

Neonatal neurological disorders can be congenital or acquired. Causes of congenital disorders are mostly genetic; inherited from the parents or due chromosomal abnormalities in the child. They can cause structural malformation or functional deficit in the brain. Acquired causes include exposure to certain toxins, birth before term, problems with labor and delivery, infections.

Metabolic disorders are separate group with genetic basis but present with unique features in first week of life. They occur due to improper handling of entrain chemical substances in the body due to enzyme defects.

Many birth-related problems may result in neurologic disorders, including:

Lack of oxygen at birth or immediately following birth: A lack of oxygen can cause severe damage to the brain. Birth asphyxia may be caused by umbilical cord prolapse, placental abruption, or too-long labor.

Some infections in the mother’s genital tract are passed on to the baby during birth: Group B streptococcus, herpes simplex virus, and cytomegalovirus are some of the infections passed to the child while giving birth. These can cause serious neurological problems.

Birth trauma to the head, resulting in bleeding inside the brain: Cephalohematoma or subdural hematoma from a traumatic birth, difficult delivery, forceps, or vacuum extraction can lead to intracranial hemorrhage and consequent neurologic damage.

In neonates, shortly after birth but at a tender age, these disorders are caused by:

Viral or bacterial infections, such as meningitis or encephalitis: Such infections of the central nervous system—bacterial meningitis or viral encephalitis—are potentially able to cause inflammation and permanent damage to the neonatal brain and lead to chronic neurological deficits.

Further more important cause is hypoglycemia(low sugar) due to improper feeding practices or low production of milk or low birth weight. They present with dull activity and seizures during 3-4 days of life. The after effects of this condition are permanent. Hence it is important to prevent this which is by simple good feeding practices.

Diagnosis of Neurological Disorders in Newborns

Our neurological team will examine at the baby in depth for his movements and responses. They also look for muscle tone, and the reflexes. Imaging diagnostics — ultrasound or MRI — provide an idea of what’s going on inside your child’s brain and spine to help you understand more clearly what may be at the root of their symptoms. At the same period, they may perform an electroencephalogram (EEG) on your baby.

Some more advanced diagnostic genetic testing are used to identify any underlying genetic or structural defects.

 Treatment of Neurological Disorders in Newborns

Treatments for neurologic disorders in newborns are based on the diagnosis. Treating the underlying cause is of utmost importance. The other symptomatic treatment like drugs for seizures will continue as required. Anti seizure medications include those for seizure control, such as phenobarbital, levetiracetam, and phenytoin. The kind of medication that is dispensed completely depends on the type of seizures and their degree of severity. Combination therapy may be necessary in some instances to have optimal control of seizures.

Surgical interventions, such as ventriculoperitoneal shunting or endoscopic third ventriculostomy, are performed on hydrocephalic newborns to drain excess fluid accumulation in the brain. These operations are conducted to lower intracranial pressure and avert further neurological damage.

After discharge early intervention therapy including Physical Therapy (PT) and Occupational Therapy (OT) and oromotor stimulation are some of the significant elements that can help hasten the development of a baby’s brain and body. Long-term developmental outcomes can be much improved by receiving regular therapy. PT works specifically on motor, strength, and coordination skills, while OT focuses on fine motor and daily living skills. Oromotor stimulation is for problems with sucking  and swallowing.

Complications

Neurological disorders show very mild to very severe complications. While some children will be disabled for life, others may only be delayed in making milestone development. This poses a dimension that each of these brain disorders can be minimized in terms of effect or complication if diagnosed early and treated effectively.

Other complications include developmental delays, cognitive impairments, motor disabilities, and sensory deficits. Those children who have serious neurological disorders need long-term care, special education, and supportive therapy to improve their quality of life. Most of the complication management and support for the child’s development comes from the multidisciplinary care team: neurologists, pediatricians, therapists, and educators.

 Conclusion

Neonatal neurological disorders are a major issue, but early detection and proper treatment may have a significant difference. The types, causes, and treatments for these neurological disorders are very important to be known either by a parent or by any healthcare provider. Many infants with neurological conditions are able to attain better developmental milestones and live much healthier with advances in medical technology and therapy.