Introduction: Seizures are the most common manifestation of neurologic compromise in the newborn period and often portend serious neurologic injury or dysfunction. Understandably, movements that mimic seizures during this period cause significant concern for parents and physicians alike and often prompt extensive diagnostic evaluation.
Here we reported a newborn patient admitted to NICU with mistaken for refractory seizures.
Case: A term 15 days female neonate presented to NICU suggestive of abnormal movements of limbs noted over the preceding 2 days. She was born by spontaneous vaginal delivery with uneventful antenatal period. The baby was admitted with a diagnosis of refractory neonatal seizures in another hospital and was treated with oral phenobarbital unsuccesfully.
Ictal and interictal EEG and cranial USG did not reveal any abnormality. These findings helped us in establishing a diagnosis of benign neonatal sleep myoclonus. The baby continued to be active in the hospital. Anticonvulsants therapy was tapered gradually and baby was sent home. On follow up, the jerks steadily reduced in frequency and disappeared by 4 weeks of life.
Discussion: Benign neonatal sleep myoclonus, a benign movement disorder that typically starts within the first 15 days of life, occurs during NREM sleep, and consists of intermittent repetitive jerks of the limbs at 2 to 3 per second.
Conclusion: Benign sleep myoclonus of infancy can be mistaken for neonatal seizures or even neonatal status epilepticus; the recognition of diagnosis is imperative to avoid unnecessary diagnostic studies and treatments.